Provider Demographics
NPI:1811138712
Name:DOOLIN, SHANA RENEE (FNP)
Entity type:Individual
Prefix:MISS
First Name:SHANA
Middle Name:RENEE
Last Name:DOOLIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:31292 ALPINE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:SHINGLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:96088-9462
Mailing Address - Country:US
Mailing Address - Phone:530-474-3390
Mailing Address - Fax:530-474-4899
Practice Address - Street 1:1275 THARP RD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2645
Practice Address - Country:US
Practice Address - Phone:530-749-3242
Practice Address - Fax:530-749-3248
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16037363L00000X
CANP16037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA487671OtherCALIFORNIA BOARD OF REGISTERED NURSING
CANP 16037OtherCALIFORNIA BOARD OF REGISTERED NURSING