MEDICARE: SHEILA ELIZABETH ANN STILLIE AG ACNP

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
1	363LA2100X	Acute Care Nurse Practitioner	95023663	CA

General Provider Information

NPI Number	:	1619676707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA ELIZABETH ANN STILLIE AG ACNP

Provider Business Mailing Address
First Line	:	547 N FARRELL DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-6214
Country	:	US
Telephone Number	:	310-403-9637
Fax Number	:

Provider Business Practice Location Address
First Line	:	547 N FARRELL DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-6214
Country	:	US
Telephone Number	:	310-403-9637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	02/27/2023

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