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Individual
MRS. STACIA KRISTINE SHIMANEK
Active
Individual
MRS. STACIA KRISTINE SHIMANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-113123
MT
363A00000X
Physician Assistant
PA2019-0026
NM
363A00000X
Physician Assistant
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
869N70
BCBSTX
TX
Enumeration date
01/10/2012
Last updated
02/19/2024
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