Provider Demographics
NPI:1639799562
Name:STRICKLAND, SHELLI ANN (RN)
Entity Type:Individual
Prefix:
First Name:SHELLI
Middle Name:ANN
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6149 GLENEAGLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-9182
Mailing Address - Country:US
Mailing Address - Phone:360-981-3432
Mailing Address - Fax:
Practice Address - Street 1:6149 GLENEAGLE AVE SW
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-9182
Practice Address - Country:US
Practice Address - Phone:360-981-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00167073163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice