Healthcare Provider Details

I. General information

NPI: 1265832802
Provider Name (Legal Business Name): SHIRLEY CROISSY ENGLISH I DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHIRLEY CROISSY APRN

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 WASHINGTON ST
HOLLYWOOD FL
33021-7353
US

IV. Provider business mailing address

PO BOX 246363
PEMBROKE PINES FL
33024-0122
US

V. Phone/Fax

Practice location:
  • Phone: 954-406-7240
  • Fax:
Mailing address:
  • Phone: 954-406-7240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN9178294
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9178294
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: