Provider Demographics
NPI:1295078343
Name:GIST, ATONYA SHEMIAH (LPN)
Entity type:Individual
Prefix:MRS
First Name:ATONYA
Middle Name:SHEMIAH
Last Name:GIST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ATONYA
Other - Middle Name:SHEMIAH
Other - Last Name:BYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:10807 FOUNTAINGROVE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6506
Mailing Address - Country:US
Mailing Address - Phone:864-219-0216
Mailing Address - Fax:
Practice Address - Street 1:212 W BOSTON AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER CITY
Practice Address - State:NC
Practice Address - Zip Code:28016-2677
Practice Address - Country:US
Practice Address - Phone:704-923-4713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC066593164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse