MEDICARE: SHYZANERA ALSTON

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN275557	GA

General Provider Information

NPI Number	:	1902742091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYZANERA ALSTON

Provider Business Mailing Address
First Line	:	100 POSTMASTER DR
Second Line	:	P.O. BOX 824
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-2838
Country	:	US
Telephone Number	:	678-988-4881
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 POSTMASTER DR
Second Line	:	P.O. BOX 824
City	:	MCDONOUGH
State	:	GA
Zip	:	30253
Country	:	US
Telephone Number	:	678-988-4881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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Directions to “ SHYZANERA ALSTON ” Practice Location

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