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1902556103
SHANACE ISAAC
HASTINGS, FL
NPI
1902556103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: FL PN5252077)
Enumeration Date
2022-03-28
Last Update Date
2022-04-01
Business Address
SHANACE ISAAC LPN
629 DANIELS ST
HASTINGS, FL 32145-3201
Phone number: 904-293-5395
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Mailing Address
SHANACE ISAAC LPN
PO BOX 101
HASTINGS, FL 32145-0101
Phone number:
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