Doctor Name: | MS. GLORIA ANN SHEALEY |
NPI Number: | 1275932345 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 13-2510 |
Business Practice Address: | 3577 Meadowglen Village Lane Apt. N Doraville, GA - 303405321 |
Business Phone Number: | 4044070006 |
Business Fax Number: | |
Mailing Address: | 3577 Meadowglen Village Lane Apt. N, DORAVILLE |
State: | GA |
Postal Code: | 303405321 |
Phone Number: | 4044070006 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2014 |
NPI Last Update Date: | 08/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246RP1900X |
License Number: | 13-2510 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Pathology |
Taxonomy Specialization: | Phlebotomy |
Taxonomy Definition: |