Healthcare Provider Details

I. General information

NPI: 1215489968
Provider Name (Legal Business Name): LAURIE SHIREY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 MEDICAL PARK LOOP STE 210
SYLVA NC
28779-5271
US

IV. Provider business mailing address

PO BOX 2597
ASHEVILLE NC
28802-2597
US

V. Phone/Fax

Practice location:
  • Phone: 828-339-3999
  • Fax: 866-340-6013
Mailing address:
  • Phone: 828-202-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009042
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: