Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1-086060 | AL |
N | 363LG0600X | Nurse Practitioner - Gerontology | 1-086060 | AL |
NPI | 1003363201 |
---|---|
Provider Name | Mrs. Shelley Charmaine Day |
First Address | Irvington, AL 36544-4011 |
Second Address | Irvington, AL 36544-4011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2016 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
226376 | (05) | AL |