Provider Demographics
NPI:1699190116
Name:SHISLER, ANNMARIE
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:SHISLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 OVERLIN RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-8950
Mailing Address - Country:US
Mailing Address - Phone:845-279-3845
Mailing Address - Fax:
Practice Address - Street 1:50 OVERLIN RD
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-8950
Practice Address - Country:US
Practice Address - Phone:845-279-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407294-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse