Provider Demographics
NPI:1073810768
Name:NANTON, SHIRLEY DENISE
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:DENISE
Last Name:NANTON
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 1:3509 RAYMOND DIEHL RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3142
Mailing Address - Country:US
Mailing Address - Phone:850-590-1150
Mailing Address - Fax:850-222-0809
Practice Address - Street 1:4708 CAPITAL CIR NW
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-7256
Practice Address - Country:US
Practice Address - Phone:850-536-0900
Practice Address - Fax:850-222-0809
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide