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NPI Code Detail

MEDICARE: DONNA SHIELDS NP

MEDICARE: DONNA SHIELDS NP
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
1363L00000XNurse Practitioner209002399IL

General Provider Information

NPI Number : 1396718987
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA SHIELDS NP
Provider Business Mailing Address
First Line : 1025 MAINE ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-4038
Country : US
Telephone Number : 217-222-6550
Fax Number :
Provider Business Practice Location Address
First Line : 1118 HAMPSHIRE ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-3027
Country : US
Telephone Number : 217-222-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 06/16/2026

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Directions to “ DONNA SHIELDS NP” Practice Location

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