Individual
MR. STEPHEN ALAN SHELLHAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5735 MEEKER RD, GREENVILLE, OH 45331-1180
(937) 548-9680
Mailing address
5735 MEEKER RD, GREENVILLE, OH 45331-1180
(937) 548-9680
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
05240
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05240
NP PEDIATRIC PRESCRIBER
OH
01
—
19990118
CERT PEDIATRIC NP
OH
05
—
2156705
—
OH
01
—
267228
RN LICENSE
OH
Enumeration date
08/27/2006
Last updated
03/07/2023
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