1841605169 NPI number — SHAYLA CHRISTINE DASCHLE APRN, CNM, MSN

Table of content: SHAYLA CHRISTINE DASCHLE APRN, CNM, MSN (NPI 1841605169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841605169 NPI number — SHAYLA CHRISTINE DASCHLE APRN, CNM, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DASCHLE
Provider First Name:
SHAYLA
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNM, MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEWIS, IRISH, WOOD, BISOM
Provider Other First Name:
SHAYLA
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841605169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1005 PARTRIDGE PL STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HELENA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59602-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-295-5199
Provider Business Mailing Address Fax Number:
406-283-8002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 PARTRIDGE PL STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59602-0528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-295-5199
Provider Business Practice Location Address Fax Number:
406-283-8002
Provider Enumeration Date:
06/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  NUR-APRN-LIC-100101 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: NUR-APRN-LIC-100101 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 105170000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: L5352 . This is a "MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 105170000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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