Individual
KARIE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3359
(802) 786-5204
Mailing address
10 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3136
AZ
363AM0700X
Medical Physician Assistant
Primary
0555.0031656
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910788
—
AZ
Enumeration date
05/31/2005
Last updated
08/16/2023
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