Provider Demographics
NPI:1023739422
Name:BRAY, SHYLA M (LPN)
Entity type:Individual
Prefix:
First Name:SHYLA
Middle Name:M
Last Name:BRAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHYLA
Other - Middle Name:M
Other - Last Name:RAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:930 BETHESDA DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0815
Mailing Address - Country:US
Mailing Address - Phone:740-569-5737
Mailing Address - Fax:
Practice Address - Street 1:930 BETHESDA DR UNIT 4
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0815
Practice Address - Country:US
Practice Address - Phone:740-569-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.155815.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse