Provider Demographics
NPI:1790561348
Name:SHAY, CAILYN MARGARET (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CAILYN
Middle Name:MARGARET
Last Name:SHAY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N LAUREL AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1579
Mailing Address - Country:US
Mailing Address - Phone:315-350-0825
Mailing Address - Fax:
Practice Address - Street 1:101 E WT HARRIS BLVD STE 4001
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1328
Practice Address - Country:US
Practice Address - Phone:704-377-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018780363LF0000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily