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NPI Code Detail

MEDICARE: KARIE SHELTON PA-C

MEDICARE: KARIE SHELTON PA-C
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
1363AM0700XMedical Physician Assistant0555.0031656VT
2363A00000XPhysician Assistant3136AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063415313
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARIE SHELTON PA-C
Provider Business Mailing Address
First Line : 10 COMMONS ST
Second Line :
City : RUTLAND
State : VT
Zip : 05701-4651
Country : US
Telephone Number : 802-747-3359
Fax Number :
Provider Business Practice Location Address
First Line : 10 COMMONS ST
Second Line :
City : RUTLAND
State : VT
Zip : 05701-4651
Country : US
Telephone Number : 802-747-3359
Fax Number : 802-786-5204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 08/16/2023

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Directions to “ KARIE SHELTON PA-C” Practice Location

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