Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
SHELLY L DERUITER
Active
Individual
SHELLY L DERUITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501017393
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0449561
—
IA
01
—
35426
WELLMARK
IA
Enumeration date
10/17/2006
Last updated
09/28/2015
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