Provider Demographics
NPI:1578964011
Name:CATLIN, SHAYRIA RAICHELLE (DNP)
Entity Type:Individual
Prefix:
First Name:SHAYRIA
Middle Name:RAICHELLE
Last Name:CATLIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:SHAYRIA
Other - Middle Name:RAICHELLE
Other - Last Name:MCCOVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:251 N BAYOU ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-5827
Mailing Address - Country:US
Mailing Address - Phone:251-690-8158
Mailing Address - Fax:251-544-2188
Practice Address - Street 1:5580 INN RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1904
Practice Address - Country:US
Practice Address - Phone:251-666-7413
Practice Address - Fax:251-666-7417
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL011846OtherMEDICARE GROUP PAYEE NUMBER
AL630000013Medicaid
AL1063439065OtherGROUP PAYEE NPI NUMBER