Individual
KELLIE L SHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-CNS, BC
Contact information
Practice address
30 HOULTON ST, PATTEN, ME 04765-3035
(866) 366-5842
Mailing address
114 W 7TH ST STE 900, AUSTIN, TX 78701-3013
(888) 285-2269
(888) 285-2269
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP211623
ME
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
2000161947
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427531801
—
MO
Enumeration date
04/20/2006
Last updated
02/10/2022
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