Provider Demographics
NPI:1619676707
Name:STILLIE, SHEILA ELIZABETH ANN (AG ACNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ELIZABETH ANN
Last Name:STILLIE
Suffix:
Gender:F
Credentials:AG ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 N FARRELL DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6214
Mailing Address - Country:US
Mailing Address - Phone:310-403-9637
Mailing Address - Fax:
Practice Address - Street 1:547 N FARRELL DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6214
Practice Address - Country:US
Practice Address - Phone:310-403-9637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023663363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care