Whalio Doctors

NPI 1619390911

Shacoya Latrece Grady, LPN

Practitioner Licensed Practical Nurse Pine Bluff, AR

Practice location

Address
3450 W 34th Ave, Pine Bluff, AR 71603-5508
Phone
(870) 534-7392
Mailing address
1202 S Nebraska St, Pine Bluff, AR 71601-6197

Registered specialties

Licensed Practical Nurse Primary
Nursing Service Providers Taxonomy 164W00000X Licence L52687 (AR)

Registry record

NPI
1619390911
Entity type
Individual
Sex (as registered)
Female
NPI issued
23 Jan 2014
Record last updated
23 Jan 2014

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.