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MRS. STACI ELAINE SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
30 E APPLE ST, STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
(937) 208-4205
Mailing address
30 E APPLE ST, STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
(937) 208-4205

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
COA.17040-NS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0117918
OH
Enumeration date
11/07/2014
Last updated
03/03/2017
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