DILLETA ANDREE SHACKELFORD (NPI# 1811209208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811209208 |
Entity Type | Individual |
Full Name | DILLETA ANDREE SHACKELFORD |
Credential | APRN |
Practice Address |
520 Griffin Ave Valdosta GA 31601-6331 |
Practice Telephone | 2292496302 |
Practice Fax Number | 2292494009 |
Mailing Telephone | 2292496302 |
Mailing Fax Number | 2292494009 |
Enumeration Date | 2010-07-14 |
Last Update Date | 2010-07-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LX0106X |
Nurse Practitioner Specialization: Occupational Health |
RN080625 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
520 GRIFFIN AVE |
City | VALDOSTA |
State | GA |
Zip Code | 31601-6331 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801887161 | James C Eutzler | Emergency Medicine | 520 Griffin Ave, Valdosta, GA 31601-6331 | 2005-11-04 |
1316573934 | Hannah Cheek | Registered Nurse | 520 Griffin Ave, Valdosta, GA 31601-6331 | 2020-03-15 |
1124548300 | Lowndes County Partnership for Health | Clinic/Center | 520 Griffin Ave, Valdosta, GA 31601-6331 | 2017-06-20 |
1801133228 | Meredith A Schanda | Registered Nurse | 520 Griffin Ave, Valdosta, GA 31601-6331 | 2013-01-04 |
1629129390 | Annette Sirmans Robinson | Nurse Practitioner | 520 Griffin Ave, Valdosta, GA 31601-6331 | 2007-01-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
1508332438 | Euniqua Lashay Williams | Contractor | 812 Lausanne Drive, Valdosta, GA 31601 | 2018-10-18 |
1457847634 | Valencia Meshay Johnson | Contractor | 1211 North Oak Street, Valdosta, GA 31601 | 2018-07-10 |
1376038042 | Restoration Care Services, LLC | Home Health | 704 Lake Park Road, Valdosta, GA 31601 | 2018-06-26 |
1609373133 | Ikea Sharnay Calhoun | Contractor | 1710 Dedo Drive, Valdosta, GA 31601 | 2018-04-11 |
1174049431 | Alexious Denson | Contractor | 900 Blanton St., Apt A16, Valdosta, GA 31601 | 2017-08-18 |
1578012258 | Clarissa Yolanda Alderman | Counselor | 4107 N Forrest Run Circle, Valdosta, GA 31601 | 2016-09-23 |
1225322613 | Andrea J. Ramirez | Counselor | 1301 Melody Ln Ste B, Valdosta, GA 31601 | 2011-06-03 |
1316248560 | L&r Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Sharper Circle, Valdosta, GU 31601 | 2010-11-04 |
1902121809 | Grace Healthcare Services Inc | Respite Care | 1010 Slater Street, Valdosta, GA 31601 | 2010-04-02 |
Find all providers in zip 31601 |
Taxonomy Code | 363LX0106X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Occupational Health |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.