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Individual
MRS. TINA M SHOLL
Active
Individual
MRS. TINA M SHOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
45445
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200002810A
—
KS
01
—
KA1634002
MEDICARE PTAN
KS
Enumeration date
07/20/2005
Last updated
09/23/2010
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