Healthcare Provider Details

I. General information

NPI: 1760532493
Provider Name (Legal Business Name): HOLLY D SHIEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 E GINTER ROAD SUNNYSIDE UNIFIED SCHOOL DISTRICT NO 12
TUCSON AZ
95706
US

IV. Provider business mailing address

2238 E GINTER ROAD SUNNYSIDE UNIFIED SCHOOL DISTRICT NO 12
TUCSON AZ
95706
US

V. Phone/Fax

Practice location:
  • Phone: 520-545-2137
  • Fax: 520-545-2120
Mailing address:
  • Phone: 520-545-2137
  • Fax: 520-545-2120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN030246
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: