Provider Demographics
NPI:1295490829
Name:GURLEY, MECHELLE RENEE (RN)
Entity type:Individual
Prefix:MRS
First Name:MECHELLE
Middle Name:RENEE
Last Name:GURLEY
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 1:11321 RAYNOR RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-7856
Mailing Address - Country:US
Mailing Address - Phone:888-758-3222
Mailing Address - Fax:888-758-4442
Practice Address - Street 1:11321 RAYNOR RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-7856
Practice Address - Country:US
Practice Address - Phone:888-758-3222
Practice Address - Fax:888-758-4442
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001215213163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health