Provider Demographics
NPI:1437247301
Name:MCNUTT, SHEILA M (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:M
Last Name:MCNUTT
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 TITAN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1197
Mailing Address - Country:US
Mailing Address - Phone:256-740-0690
Mailing Address - Fax:256-740-0694
Practice Address - Street 1:156 TITAN DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1197
Practice Address - Country:US
Practice Address - Phone:256-740-0690
Practice Address - Fax:256-740-0694
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068459363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS51430Medicare UPIN