Provider Demographics
NPI:1295534592
Name:SALLEY, IRENE NAA-SHORME (MSN RN)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:NAA-SHORME
Last Name:SALLEY
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 CENTRAL PARK AVE
Mailing Address - Street 2:STE E #513
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8803
Mailing Address - Country:US
Mailing Address - Phone:919-441-0543
Mailing Address - Fax:
Practice Address - Street 1:222 CENTRAL PARK AVE
Practice Address - Street 2:STE E #513
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8803
Practice Address - Country:US
Practice Address - Phone:919-441-0543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC240857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty