Provider Demographics
NPI:1386302693
Name:LOYD, SHALA SHENELL (CNA, HOMEMAKER)
Entity type:Individual
Prefix:MRS
First Name:SHALA
Middle Name:SHENELL
Last Name:LOYD
Suffix:
Gender:F
Credentials:CNA, HOMEMAKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 RIVERPLACE BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-9032
Mailing Address - Country:US
Mailing Address - Phone:668-604-2001
Mailing Address - Fax:904-527-1333
Practice Address - Street 1:1301 RIVERPLACE BLVD STE 800
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-9032
Practice Address - Country:US
Practice Address - Phone:668-604-2001
Practice Address - Fax:904-527-1333
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL237653253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care