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General NPI Number Information
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NPI Number | 1508999467
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Entity Type | Individual
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Provider Name | SHAWN DESIREE FLOYD I LPN
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 212 ADAMS CT
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City | POTTERVILLE
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State | MI
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Zip | 48876-9501
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Country | US
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Telephone | 517-599-0425
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Fax | 419-492-9506
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Provider Business Mailing Address
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Address Line | 212 ADAMS CT
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City | POTTERVILLE
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State | MI
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Zip | 48876-9501
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Country | US
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Telephone | 517-599-0425
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Fax | 419-492-9506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN113942
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703109919
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License Number State | MI
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