Provider Demographics
NPI:1346583846
Name:DALAI, SHIRIN MARYAH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHIRIN
Middle Name:MARYAH
Last Name:DALAI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4876 BAXTER RD.
Mailing Address - Street 2:FIRST CHOICE MEDICAL CARE
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-671-7777
Mailing Address - Fax:757-671-7778
Practice Address - Street 1:4876 BAXTER RD.
Practice Address - Street 2:FIRST CHOICE MEDICAL CARE
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-671-7777
Practice Address - Fax:757-671-7778
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001204321163W00000X
VA0024170759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse