Individual
SHELLEY WILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
221572
SC
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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