Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-091496 | AL |
NPI | 1023442746 |
---|---|
Provider Name | Shara Marie Viles |
First Address | Trussville, AL 35173-4647 |
Second Address | Birmingham, AL 35294-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2013 |
Last Update Date | 29/08/2013 |