Provider Demographics
NPI:1326861139
Name:CODREY, SHAYNA ELLEN (FNP)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:ELLEN
Last Name:CODREY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-4805
Mailing Address - Fax:757-668-8499
Practice Address - Street 1:1181 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2437
Practice Address - Country:US
Practice Address - Phone:757-668-4600
Practice Address - Fax:757-668-4605
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024191683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily