Provider Demographics
NPI:1326426958
Name:GOLDEN DAYS, LLC
Entity Type:Organization
Organization Name:GOLDEN DAYS, LLC
Other - Org Name:GOLDEN DAYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAAM
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-503-1490
Mailing Address - Street 1:15480 ANNAPOLIS RD
Mailing Address - Street 2:STE 202
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1852
Mailing Address - Country:US
Mailing Address - Phone:301-503-1490
Mailing Address - Fax:
Practice Address - Street 1:15480 ANNAPOLIS RD
Practice Address - Street 2:STE 202
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1852
Practice Address - Country:US
Practice Address - Phone:301-503-1490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF07141329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty