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General NPI Number Information
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NPI Number | 1316286925
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Entity Type | Individual
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Provider Name | CARLA J SHILTS RN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 801 HAZEN ST
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City | PAW PAW
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State | MI
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Zip | 49079-2008
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Country | US
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Telephone | 517-716-5081
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Fax | 269-657-6902
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | PAW PAW
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State | MI
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Zip | 49079-0249
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Country | US
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Telephone | 269-657-5574
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Fax | 269-657-6902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704238767
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License Number State | MI
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