Individual
SHAQUALYN TAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4005 N COLLEGE AVE, JACKSON, AL 36545-2024
(251) 744-6084
Mailing address
PO BOX 306491, NASHVILLE, TN 37230-6491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-150563
AL
Other
Enumeration date
07/04/2020
Last updated
03/21/2024
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