Individual
MRS. SHELIEGH SHILLITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7542 BROOKFIELD DR, LEWISVILLE, NC 27023-9649
(336) 486-1852
Mailing address
7542 BROOKFIELD DR, LEWISVILLE, NC 27023-9649
(336) 486-1852
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
169496
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29354682
PART B MEDICARE
NC
Enumeration date
11/05/2019
Last updated
11/05/2019
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