Individual
STEPHANIE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 N SALVATION ST, WASILLA, AK 99654-1367
(907) 602-5216
Mailing address
4150 N SALVATION ST, WASILLA, AK 99654-1367
(907) 602-5216
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2207396
AK
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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