Provider Demographics
NPI:1730762667
Name:BEARD, SHAYLA (OWNER)
Entity type:Individual
Prefix:MISS
First Name:SHAYLA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HUNTERS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9091
Mailing Address - Country:US
Mailing Address - Phone:808-990-0448
Mailing Address - Fax:
Practice Address - Street 1:208 HUNTERS RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9091
Practice Address - Country:US
Practice Address - Phone:808-990-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health