Provider Demographics
NPI:1881314649
Name:MATELIS, SHAYNA ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:ELIZABETH
Last Name:MATELIS
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 1:13360 W CREOSOTE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-8213
Mailing Address - Country:US
Mailing Address - Phone:623-853-6843
Mailing Address - Fax:
Practice Address - Street 1:13360 W CREOSOTE DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-8213
Practice Address - Country:US
Practice Address - Phone:623-853-6843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ259456163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine