Provider Demographics
NPI:1568896157
Name:POURSAIED, SHAHLA (SHAHLA POURSAIED)
Entity Type:Individual
Prefix:
First Name:SHAHLA
Middle Name:
Last Name:POURSAIED
Suffix:
Gender:F
Credentials:SHAHLA POURSAIED
Other - Prefix:
Other - First Name:SHAHLA
Other - Middle Name:
Other - Last Name:POURSAIED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1718 ALM DR NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-2148
Mailing Address - Country:US
Mailing Address - Phone:256-536-2759
Mailing Address - Fax:
Practice Address - Street 1:1718 ALM DR NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-2148
Practice Address - Country:US
Practice Address - Phone:256-536-2759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-085209363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care