Individual
SHELLEY BIDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 CAMPBELL AVE, PRESCOTT, AZ 86301-1211
(925) 717-3276
Mailing address
300 E GURLEY ST, PRESCOTT, AZ 86301-3823
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN213918
AZ
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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