Individual
NICOLE PAULSON SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
424 N BROAD ST, NEW TAZEWELL, TN 37825-6606
(423) 869-7193
(423) 869-7195
Mailing address
PO BOX 367, HARROGATE, TN 37752-0367
(423) 869-7193
(423) 869-7195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009-01338
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000615
—
TN
Enumeration date
04/16/2008
Last updated
11/23/2020
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