Provider Demographics
NPI:1760647879
Name:SHAULIS, JANET MARIAN (RN,BSN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIAN
Last Name:SHAULIS
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:MARIAN
Other - Last Name:HUNNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2039 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-1040
Mailing Address - Country:US
Mailing Address - Phone:308-641-0773
Mailing Address - Fax:
Practice Address - Street 1:2039 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:NE
Practice Address - Zip Code:69357-1040
Practice Address - Country:US
Practice Address - Phone:308-641-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2508146L00000X
LARN079839163WE0003X
CA687968163WE0003X
NE54448163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No163WE0003XNursing Service ProvidersRegistered NurseEmergency