Provider Demographics
NPI:1508190174
Name:SHILLING, STEPHANIE MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:SHILLING
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1851
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-1851
Mailing Address - Country:US
Mailing Address - Phone:928-649-7899
Mailing Address - Fax:928-649-7898
Practice Address - Street 1:294 W STATE ROUTE 89A
Practice Address - Street 2:SUITE 209
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3754
Practice Address - Country:US
Practice Address - Phone:928-649-7899
Practice Address - Fax:928-649-7898
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP3450367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife