Individual
GINGER SHULLANBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
245 TERRACINA BLVD, REDLANDS, CA 92373-4852
(909) 793-3311
(909) 335-4105
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209001147
IL
363L00000X
Nurse Practitioner
Primary
95007553
CA
363L00000X
Nurse Practitioner
AP128129
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NON-PARTICIPATING
—
IL
Enumeration date
08/30/2006
Last updated
02/05/2020
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