Provider Demographics
NPI:1184802977
Name:SHEMWELL, TOBY NICOLE (MEDIC)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:NICOLE
Last Name:SHEMWELL
Suffix:
Gender:F
Credentials:MEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 3RD AVE UNIT #361
Mailing Address - Street 2:
Mailing Address - City:FT.RUCKER
Mailing Address - State:AL
Mailing Address - Zip Code:36362
Mailing Address - Country:US
Mailing Address - Phone:334-379-7988
Mailing Address - Fax:
Practice Address - Street 1:8360 3RD AVE UNIT #361
Practice Address - Street 2:
Practice Address - City:FT.RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362
Practice Address - Country:US
Practice Address - Phone:334-379-7988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXB1769428146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic