Provider Demographics
NPI: | 1215167903 |
---|---|
Name: | SHIELDS, YOLANDA GAIL (CRT, AE-C) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | YOLANDA |
Middle Name: | GAIL |
Last Name: | SHIELDS |
Suffix: | |
Gender: | F |
Credentials: | CRT, AE-C |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 650 JOEL DR |
Mailing Address - Street 2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL |
Mailing Address - City: | FORT CAMPBELL |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 42223-5318 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 270-956-0141 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 650 JOEL DR |
Practice Address - Street 2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL |
Practice Address - City: | FORT CAMPBELL |
Practice Address - State: | KY |
Practice Address - Zip Code: | 42223-5318 |
Practice Address - Country: | US |
Practice Address - Phone: | 270-956-0141 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-07-16 |
Last Update Date: | 2009-07-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational |
No | 2278C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Critical Care |
No | 2278E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Emergency Care |
No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No | 2278P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Function Technologist |