Provider Demographics
NPI:1336441500
Name:KNOWLES, SHIREEN S (CRNP)
Entity Type:Individual
Prefix:
First Name:SHIREEN
Middle Name:S
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE D100
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6765
Mailing Address - Country:US
Mailing Address - Phone:251-607-6117
Mailing Address - Fax:251-219-0746
Practice Address - Street 1:6701 AIRPORT BLVD STE D100
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6765
Practice Address - Country:US
Practice Address - Phone:251-607-6117
Practice Address - Fax:251-219-0746
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1097798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I504829Medicare PIN
MS302I509986Medicare PIN