Provider Demographics
NPI:1982869681
Name:TAYLOR-GETER, SHUNTA C (CRNA)
Entity Type:Individual
Prefix:
First Name:SHUNTA
Middle Name:C
Last Name:TAYLOR-GETER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:ATTN: DEPT 1717
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:ROOM JT845
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-1900
Practice Address - Country:US
Practice Address - Phone:205-934-7072
Practice Address - Fax:205-975-5963
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN143629163W00000X
TNAPN13625367500000X
AL1-137540367500000X
GARN184462367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8053564Medicaid
TNP00747429OtherRAILROAD MEDICARE
GA427087670AMedicaid
AL110677Medicaid
GAN475530OtherWELLCARE (GA MEDICAID)
TN4194916OtherBLUE CROSS BLUE SHIELD OF TN
TN1513123Medicaid
GAN475530OtherWELLCARE (GA MEDICAID)