Provider Demographics
NPI:1790325991
Name:PAUL, SHELIA ANN
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:ANN
Last Name:PAUL
Suffix:
Gender:F
Credentials:
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 337
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-0337
Mailing Address - Country:US
Mailing Address - Phone:850-614-6071
Mailing Address - Fax:
Practice Address - Street 1:603 SCENIC HILL CIRCLE
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425
Practice Address - Country:US
Practice Address - Phone:850-614-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator