Doctor Name: | STEPHANIE SHIREY |
NPI Number: | 1043672504 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN148353 |
Business Practice Address: | 116 Haymarket Ct Bossier City, LA - 711118228 |
Business Phone Number: | 4146516521 |
Business Fax Number: | |
Mailing Address: | 116 Haymarket Ct, BOSSIER CITY |
State: | LA |
Postal Code: | 711118228 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/24/2016 |
NPI Last Update Date: | 03/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | RN148353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |