Most Relevant Information
Provider Data
| NPI Number: | 1003198524 |
| Provider Name: | SHANNA WOOTEN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN144755 |
Most Important Dates
| Enumeration Date: | 09/10/2011 |
| Last Updated: | 09/10/2011 |
Provider Practice Location
2916 SPRING FALLS DR
WEST CARROLLTON
OH
454493464
Practice Location Phone/Fax
| Phone: | 9375202124 |
| Fax: |
Provider Mailing Location
2916 SPRING FALLS DR
WEST CARROLLTON
OH
454493464
Provider Mailing Phone/Fax
| Phone: | 9375202124 |
| Fax: |