Provider Demographics
NPI:1629595640
Name:BOUIE, SHAYLA (RMA/ CNA)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:BOUIE
Suffix:
Gender:F
Credentials:RMA/ CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 RIVERDALE RD APT D17
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-6941
Mailing Address - Country:US
Mailing Address - Phone:404-644-5857
Mailing Address - Fax:
Practice Address - Street 1:5420 RIVERDALE RD APT D17
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:404-644-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
No374U00000XNursing Service Related ProvidersHome Health Aide
No171W00000XOther Service ProvidersContractor
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide