Individual
RODERICK DARNELL SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2105 E SOUTH BLVD, MONTGOMERY, AL 36116-2409
(334) 288-2100
Mailing address
90 EMERALD DR, PIKE ROAD, AL 36064-2932
(334) 294-8029
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
1-120663
AL
Other
Enumeration date
07/15/2017
Last updated
07/15/2017
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