Basic Information
Provider Information
NPI: 1386001873
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBNETT
FirstName: SHELBY
MiddleName: MAELYNE
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 635 W COLLEGE ST
Address2:  
City: FLORENCE
State: AL
PostalCode: 356305313
CountryCode: US
TelephoneNumber: 2567643431
FaxNumber: 2567687462
Practice Location
Address1: 635 W COLLEGE ST
Address2:  
City: FLORENCE
State: AL
PostalCode: 356305313
CountryCode: US
TelephoneNumber: 2567643431
FaxNumber: 2567687462
Other Information
ProviderEnumerationDate: 01/28/2016
LastUpdateDate: 01/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X1-146991ALY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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