Individual
MS. CHRISTINE HOLLY SHANTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
15855 19 MILE RD, EMERGENCY DEPT, CLINTON TOWNSHIP, MI 48038-3504
(586) 263-2601
(586) 263-2589
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704226543
MI
363LA2100X
Acute Care Nurse Practitioner
4704226543
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12067480
CAQH
MI
Enumeration date
12/31/2009
Last updated
07/24/2012
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