Provider Demographics
NPI:1336510437
Name:SHIRLEY, KARLYE (CRNP)
Entity Type:Individual
Prefix:
First Name:KARLYE
Middle Name:
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 RACHELLE CT
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-4731
Mailing Address - Country:US
Mailing Address - Phone:724-875-6177
Mailing Address - Fax:
Practice Address - Street 1:625 RACHELLE CT
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-4731
Practice Address - Country:US
Practice Address - Phone:724-875-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily