Provider Demographics
NPI:1437456050
Name:REICH, SHAWNA MICHELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:MICHELLE
Last Name:REICH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1183
Mailing Address - Country:US
Mailing Address - Phone:251-342-2641
Mailing Address - Fax:251-343-9507
Practice Address - Street 1:100 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 3A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1183
Practice Address - Country:US
Practice Address - Phone:251-342-2641
Practice Address - Fax:251-343-9507
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-144326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-53174OtherBLUE CROSS OF ALABAMA
AL102I503756Medicare PIN