Provider Demographics
NPI:1164979050
Name:STREYLE, SHAINA
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:STREYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4335
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-4335
Mailing Address - Country:US
Mailing Address - Phone:605-553-3460
Mailing Address - Fax:
Practice Address - Street 1:1308 DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-6616
Practice Address - Country:US
Practice Address - Phone:605-553-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator