Harrell, Shirley Lavon

Harrell, Shirley Lavon is an sole proprietor health care provider with primary practice located at 1101 Ocilla Rd , Douglas GA 31533-2207. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Harrell, Shirley Lavon can be contacted via phone (912) 384-1900.

Contact Information

Primary practice address
1101 Ocilla Rd Douglas GA 31533-2207
Phone: (912) 384-1900
Fax: (912) 389-2112
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X RN056220 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN056220 Georgia

Profile Details

NPI number 1629041355
LBN Legal business name Harrell, Shirley Lavon
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2006
Last updated Jun 24th, 2021 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1629041355 NPPES
Georgia MEDICAID 804987669A
Georgia MEDICAID 804987669B

Popular Providers