Provider Demographics
NPI:1700436375
Name:SHILSON, KRISTIN ANNE (APRN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:ANNE
Last Name:SHILSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N COPPERKNOLL CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-5148
Mailing Address - Country:US
Mailing Address - Phone:347-225-4827
Mailing Address - Fax:
Practice Address - Street 1:7750 E BROADWAY BLVD STE A100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3901
Practice Address - Country:US
Practice Address - Phone:520-327-1529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001651-C-NP363LP0808X
TX927043363LP0808X
AZ232042363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health