Provider Demographics
NPI:1538931043
Name:WHITE, SHELBY LAUREN (RN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LAUREN
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LAUREN
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:851 WOOD TRACE CIR
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-6802
Mailing Address - Country:US
Mailing Address - Phone:205-266-6132
Mailing Address - Fax:
Practice Address - Street 1:851 WOOD TRACE CIR
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-6802
Practice Address - Country:US
Practice Address - Phone:205-266-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse