Provider Demographics
NPI:1770005944
Name:SHAY, SARAH (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SHAY
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 1:1602 S VALRICO RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4515
Mailing Address - Country:US
Mailing Address - Phone:727-303-6194
Mailing Address - Fax:
Practice Address - Street 1:701 6TH ST
Practice Address - Street 2:BAYFRONT HEALTH ST PETERSBURG
Practice Address - City:ST.PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-893-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9395773163W00000X
FLF03180725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse