Roderick Darnell Shine
Nurse Practitioner - Neonatal (Critical Care)
2105 E South Blvd
Montgomery
, Alabama 36116-2409
Roderick Darnell Shine
Nurse Practitioner - Neonatal (Critical Care)
2105 E South Blvd
Montgomery
, Alabama 36116-2409
(334) 294-8029
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About
Features
Specialties
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Roderick Darnell Shine
- 90 Emerald Dr
- Pike Road, AL
- Zip : 36064-2932
- Phone : (334) 294-8029
Second Address
- Roderick Darnell Shine
- 2105 E South Blvd
- Montgomery, AL
- Zip : 36116-2409
- Phone : (334) 288-2100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1-120663 | AL |
National Provider Identifier
| NPI | 1215459854 |
|---|---|
| Provider Name | Roderick Darnell Shine |
| First Address | Pike Road, AL 36064-2932 |
| Second Address | Montgomery, AL 36116-2409 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/07/2017 |
| Last Update Date | 15/07/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.