Individual
MRS. SHELIA A SANCILLO TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R857901
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01484713
—
MS
Enumeration date
10/26/2011
Last updated
12/02/2016
Update your record
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