Provider Demographics
NPI:1235425083
Name:SHAKYA, SAUJANYA (CRNP)
Entity Type:Individual
Prefix:MR
First Name:SAUJANYA
Middle Name:
Last Name:SHAKYA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 DEERFOOT PKWY
Mailing Address - Street 2:
Mailing Address - City:PINSON
Mailing Address - State:AL
Mailing Address - Zip Code:35126-3093
Mailing Address - Country:US
Mailing Address - Phone:205-680-9898
Mailing Address - Fax:205-680-3300
Practice Address - Street 1:6725 DEERFOOT PKWY
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3093
Practice Address - Country:US
Practice Address - Phone:205-680-9898
Practice Address - Fax:205-680-3300
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily