Grant, Shaylon Carlene
Grant, Shaylon Carlene is an individual health care provider with primary practice located at 1800 E Lake Shore Dr , Decatur IL 62521-3810. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Grant, Shaylon Carlene can be contacted via phone (217) 422-6100.Contact Information
Primary practice address
1800 E Lake Shore Dr
Decatur IL 62521-3810
Phone: (217) 422-6100
Fax: (217) 422-3217
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN0000015750 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209010154 | Illinois |
Profile Details
| NPI number | 1992094742 |
|---|---|
| LBN Legal business name | Grant, Shaylon Carlene |
| Credentials | FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2011 |
| Last updated | Apr 18th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992094742 | NPPES |
| Illinois | Other | P01273952 | RAILROAD |
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