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Misty Shadduck, LPN
Licensed Practical Nurse in Mesa, Arizona
NPI 1043080476

Misty Shadduck is a Licensed Practical Nurse based in Gilbert, AZ. Misty Shadduck practices in Mesa, AZ and has the professional credentials of LPN. The NPI Number for Misty Shadduck is 1043080476 and holds a License No. 32549101 (Arizona).

The current practice location address for Misty Shadduck is 455 N Mesa Dr Ste 8E, Mesa, AZ and can be reached out via phone at 937-768-2544 and via fax at 877-991-6652.

Location: 455 N Mesa Dr Ste 8E, Mesa, AZ, 85296-1374
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043080476
Provider Name
Misty Shadduck
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
455 N Mesa Dr Ste 8E, Mesa, AZ, 85296-1374
Phone Number
937-768-2544
Fax Number
877-991-6652
Provider Enumeration Date
01/05/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
455 N Mesa Dr Ste 8E
City
Mesa
State
Arizona
Zip
85201-5996
Phone Number
937-768-2544
Fax Number
877-991-6652
person
Provider Business Mailing Address Details
Address
455 N Mesa Dr Ste 8E
City
Mesa
State
Arizona
Zip
85201-5996
Phone Number
937-768-2544
Fax Number
877-991-6652
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
()
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
32549101 (New York)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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