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NPI Profile for SHALESE AYCOCK in VALDOSTA, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1386331734 |
|
| Status | Active | |
| Credentials | NP (Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 04/18/2023 | |
| Last updated | 03/14/2024 - About 2 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHALESE AYCOCK
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SHALESE AYCOCK, NP