Provider Demographics
NPI:1790038396
Name:JOSEY, SHIRLEY AUDREY
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:AUDREY
Last Name:JOSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7324 WILLOW SPGS CIR N
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:561-649-6227
Mailing Address - Fax:561-649-6227
Practice Address - Street 1:7324 WILLOW SPGS CIR N.
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436
Practice Address - Country:US
Practice Address - Phone:561-649-6227
Practice Address - Fax:561-649-6227
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL#6905710372500000X
FL6905710372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider