Provider Demographics
NPI:1427875384
Name:STRYD, SHAYANNA (BSN, RN)
Entity type:Individual
Prefix:
First Name:SHAYANNA
Middle Name:
Last Name:STRYD
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 E PALMER ST APT 301
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3837
Mailing Address - Country:US
Mailing Address - Phone:248-954-1183
Mailing Address - Fax:
Practice Address - Street 1:5557 CASS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3615
Practice Address - Country:US
Practice Address - Phone:248-954-1183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704375574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse