Healthcare Provider Details

I. General information

NPI: 1346378593
Provider Name (Legal Business Name): SHINAR EUGENIA HURD BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 MEDICAL CENTER DR
COLUMBIA TN
38401-6402
US

IV. Provider business mailing address

PO BOX 358
FAYETTEVILLE TN
37334-0358
US

V. Phone/Fax

Practice location:
  • Phone: 931-212-8715
  • Fax: 931-433-8911
Mailing address:
  • Phone: 931-212-8715
  • Fax: 931-433-8911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number3918B
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: