Provider Demographics
NPI:1174359855
Name:BYRD, SHALEA MARIE
Entity type:Individual
Prefix:
First Name:SHALEA
Middle Name:MARIE
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7129 ROSSMAN CT
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9114
Mailing Address - Country:US
Mailing Address - Phone:614-441-3011
Mailing Address - Fax:
Practice Address - Street 1:3830 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-5404
Practice Address - Country:US
Practice Address - Phone:614-566-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula