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NPI Code Detail

MEDICARE: MS. SHAYLA CRAVENS

MEDICARE:  MS. SHAYLA  CRAVENS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133N00000XNutritionist

General Provider Information

NPI Number : 1770239329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAYLA CRAVENS
Provider Business Mailing Address
First Line : 3505 CHAPEL LN
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9415
Country : US
Telephone Number : 502-554-2693
Fax Number :
Provider Business Practice Location Address
First Line : 3505 CHAPEL LN
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9415
Country : US
Telephone Number : 502-554-2693
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2022
Last Update Date : 02/22/2022

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Directions to “ MS. SHAYLA CRAVENS ” Practice Location

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