Provider Demographics
NPI:1689142028
Name:SHIVERS, BILLIE (RN)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:SHIVERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 CRYSTAL TER
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3848
Mailing Address - Country:US
Mailing Address - Phone:973-979-1444
Mailing Address - Fax:
Practice Address - Street 1:2108 CRYSTAL TER
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3848
Practice Address - Country:US
Practice Address - Phone:973-979-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-03
Last Update Date:2018-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10378500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse