Provider Demographics
NPI:1922749308
Name:SILCOTT, SHATOYA LYNAE (RN)
Entity Type:Individual
Prefix:
First Name:SHATOYA
Middle Name:LYNAE
Last Name:SILCOTT
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 1:4404 TREE CORNERS PKWY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6174
Mailing Address - Country:US
Mailing Address - Phone:228-217-2928
Mailing Address - Fax:
Practice Address - Street 1:5905 STEWART PKWY
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2371
Practice Address - Country:US
Practice Address - Phone:770-949-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904426163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health