SHIRLEY S MANDEVILLE FNP NPI 1538113816

NPI Information

NPI: 1538113816
Provider Name: SHIRLEY S MANDEVILLE, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
601 ELMWOOD AVE
BOX SURG
ROCHESTER, NY
ZIP 14642
Phone: (585) 276-3332
Get Directions

Shirley S Mandeville, FNP is a family nurse practitioner in Rochester, NY. Shirley S Mandeville, FNP NPI is 1538113816. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

601 ELMWOOD AVE
BOX SURG
ROCHESTER, NY
ZIP 14642-413
Phone: (585) 276-3332

The enumeration date for this NPI number is 5/20/2006 and was last updated on 7/18/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F331695-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9512361	OTHER	NEW YORK	INDEPENDENT HEALTH
2	P019331695	OTHER	NEW YORK	ROCH BS
3	J400026181	MEDICARE PIN	NEW YORK
4	S44098	MEDICARE UPIN	NEW YORK
5	01791166	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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