NPI 1043080476
Misty Shadduck, LPN
Practice location
- Address
- 455 N Mesa Dr STE 8e, Mesa, AZ 85201-5996
- Phone
- (937) 768-2544
- Fax
- (877) 991-6652
- Mailing address
- 70 S Val Vista Dr # A3-618, Gilbert, AZ 85296-1374
Registered specialties (3)
Licensed Practical Nurse
Primary
Licensed Practical Nurse
Student in an Organized Health Care Education/Training Program
Registry record
- NPI
- 1043080476
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 5 Jan 2024
- Record last updated
- 5 Jan 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.