Individual
JOANNE A SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
P O BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1058100
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000050797
—
AL
01
—
051050797
BCBS OF AL
AL
01
—
P00101405
RR MEDICARE
AL
01
—
S85650
VIVA
AL
Enumeration date
08/11/2006
Last updated
03/01/2013
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