Provider Demographics
NPI:1639584097
Name:BAILEY, SHANYN (NP)
Entity Type:Individual
Prefix:
First Name:SHANYN
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7700
Mailing Address - Country:US
Mailing Address - Phone:205-547-2323
Mailing Address - Fax:205-995-0955
Practice Address - Street 1:10 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-7700
Practice Address - Country:US
Practice Address - Phone:205-547-2323
Practice Address - Fax:205-995-0955
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-130583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily