Individual
CASEY SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN230217
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175687D
—
GA
05
—
003175687F
—
GA
Enumeration date
01/26/2016
Last updated
11/06/2024
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