Provider Demographics
NPI:1427812361
Name:HAMBY, SHANE (RN)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:HAMBY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 MILLS GAP RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8702
Mailing Address - Country:US
Mailing Address - Phone:347-397-7947
Mailing Address - Fax:
Practice Address - Street 1:826 MILLS GAP RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-8702
Practice Address - Country:US
Practice Address - Phone:347-397-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI98524163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator