Provider Demographics
NPI:1124659487
Name:PEOPLES, SHANITA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SHANITA
Middle Name:
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MIDTOWN PARK W STE B-1
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4139
Mailing Address - Country:US
Mailing Address - Phone:251-295-5110
Mailing Address - Fax:251-378-8248
Practice Address - Street 1:23 MIDTOWN PARK W STE B-1
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4139
Practice Address - Country:US
Practice Address - Phone:251-295-5110
Practice Address - Fax:251-378-8248
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-126986363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care