SHANTAVIS SHANTRELL FAYSON

GAINESVILLE, FL
NPI1992466171
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: FL  5242314)
Enumeration Date2022-01-10
Last Update Date2022-01-10
Business Address
SHANTAVIS SHANTRELL FAYSON
2802 NE 53RD CT # 194
GAINESVILLE, FL 32609-2625
Phone number: 850-933-1399
Mailing Address
SHANTAVIS SHANTRELL FAYSON
2802 NE 53RD CT # 194
GAINESVILLE, FL 32609-2625
Phone number: 850-933-1399
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