# SHIRLEY LAVON HARRELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1629041355
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WE0003X | Emergency Registered Nurse | RN056220 | GA | — |
| 363L00000X | Nurse Practitioner | RN056220 | GA | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 06/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 804987669A | — | GA |
| 05 | — | 804987669B | — | GA |