Shantavis Shantrell Fayson
NPI #1992466171 in Gainesville, Florida
Provider Information
- NPI Number
- 1992466171
- Entity Type
- Individual
- Name
- Shantavis Shantrell Fayson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Jan 10, 2022
- Last Updated
- Jan 10, 2022
Practice Location
- Address
- 2802 NE 53RD CT # 194
- City
- Gainesville
- State
- Florida
- ZIP Code
- 32609-2625
- Phone
- (850) 933-1399
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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