Shanise Yvonne Petticord
Shanise Yvonne Petticord is a Licensed Practical Nurse in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2024.
- Licensed in
- MI
- In the registry since
- 2024
Practice location Address checks out
5736 Audubon RdDetroit, MI 48224-2665
Phone: (313) 624-1067
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Licensed Practical Nurse (primary) | Taxonomy 164W00000X · Licence 4703091434 (MI) |
|---|
Record details
| NPI number | 1700639101 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | April 8, 2024 |
| Last updated in NPPES | April 8, 2024 |
| Certification date | April 8, 2024 |
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