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General NPI Number Information
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NPI Number | 1780967687
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Entity Type | Individual
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Provider Name | SHIRLEY DANIEL N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 3RD STREET & INNER LOOP ROAD BUILDING 166, ROOM 414
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City | FORT IRWIN
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State | CA
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Zip | 92310-5109
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Country | US
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Telephone | 760-380-5388
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 105109
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City | FORT IRWIN
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State | CA
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Zip | 92310-5109
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Country | US
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Telephone | 760-380-5388
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 530115
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 116553
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 75462
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License Number State | KS
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