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General NPI Number Information
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NPI Number | 1467058362
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Entity Type | Individual
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Provider Name | SHAYLYN PROULX CRPN
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 170 JENNIFER RD STE 202
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7909
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Country | US
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Telephone | 443-291-8090
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Fax | 443-856-2106
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Provider Business Mailing Address
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Address Line | 224 MAYO RD STE A
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City | EDGEWATER
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State | MD
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Zip | 21037-2951
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Country | US
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Telephone | 410-956-6302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R255619
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R255619
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License Number State | MD
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