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General NPI Number Information
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NPI Number | 1902132764
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Entity Type | Individual
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Provider Name | KRISTI LYNN SHURDEN FNPBC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 56 DUTCH LN
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City | COLUMBUS
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State | MS
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Zip | 39702-5500
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Country | US
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Telephone | 662-329-3808
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Fax |
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Provider Business Mailing Address
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Address Line | 49494 HIGHWAY 17
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City | SULLIGENT
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State | AL
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Zip | 35586-4454
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Country | US
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Telephone | 205-698-7111
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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 | 1-123955
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License Number State | AL
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