Provider Demographics
NPI:1316541162
Name:SPELLMAN, SHAYLAH RAE (APRN)
Entity Type:Individual
Prefix:
First Name:SHAYLAH
Middle Name:RAE
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHAYLAH
Other - Middle Name:RAE
Other - Last Name:MORSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:75 LAMBERT LIND HWY
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1131
Mailing Address - Country:US
Mailing Address - Phone:401-681-4274
Mailing Address - Fax:401-615-2805
Practice Address - Street 1:75 LAMBERT LIND HWY
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1131
Practice Address - Country:US
Practice Address - Phone:401-681-4274
Practice Address - Fax:401-615-2805
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICAPRN02507363LP0808X
RIAPRN02507363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health