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NPI Code Detail

MEDICARE: SHAYNA ELIZABETH MATELIS RN

MEDICARE:   SHAYNA ELIZABETH MATELIS  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0200XCritical Care Medicine Registered Nurse259456AZ

General Provider Information

NPI Number : 1881314649
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYNA ELIZABETH MATELIS RN
Provider Business Mailing Address
First Line : 13360 W CREOSOTE DR
Second Line :
City : PEORIA
State : AZ
Zip : 85383-8213
Country : US
Telephone Number : 623-853-6843
Fax Number :
Provider Business Practice Location Address
First Line : 13360 W CREOSOTE DR
Second Line :
City : PEORIA
State : AZ
Zip : 85383-8213
Country : US
Telephone Number : 623-853-6843
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2022
Last Update Date : 08/31/2022

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Directions to “ SHAYNA ELIZABETH MATELIS RN” Practice Location

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