Healthcare Provider Details

I. General information

NPI: 1851184261
Provider Name (Legal Business Name): SOUTHERN PERINATAL RN CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 ABERDEEN PKWY
PANAMA CITY FL
32405-6457
US

IV. Provider business mailing address

508B FLORIDA AVE
LYNN HAVEN FL
32444-1736
US

V. Phone/Fax

Practice location:
  • Phone: 850-348-5254
  • Fax:
Mailing address:
  • Phone: 850-348-5254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLEE ALAYNA SHALING
Title or Position: FOUNDER/CEO
Credential: BSN, RN
Phone: 850-851-9833