Provider Demographics
NPI:1962055590
Name:SHAVER, VICTORIA AILEEN (NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:AILEEN
Last Name:SHAVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:AILEEN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:
Practice Address - Street 1:825 WINDMILL XING
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6630
Practice Address - Country:US
Practice Address - Phone:478-283-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245207363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care