Provider Demographics
NPI:1518391085
Name:HOLLIDAY, SHIRREE SHINELLEC (CNA)
Entity Type:Individual
Prefix:MR
First Name:SHIRREE
Middle Name:SHINELLEC
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 N FAIRGROUNDS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-5130
Mailing Address - Country:US
Mailing Address - Phone:731-225-4412
Mailing Address - Fax:
Practice Address - Street 1:248 N FAIRGROUNDS ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-5130
Practice Address - Country:US
Practice Address - Phone:731-225-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN115963376K00000X
MSA070530376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide