person
Nicole Marie Shields, PA-C
Medical Physician Assistant in Mount Clemens, Michigan
NPI 1073999629

Nicole Marie Shields is a Medical Physician Assistant based in Chicago, MI and is specialized in Medical. Nicole Marie Shields practices in Mount Clemens, MI and has the professional credentials of PA-C. The NPI Number for Nicole Marie Shields is 1073999629 and holds a License No. 5601007332 (Michigan).

The current practice location address for Nicole Marie Shields is 133 S Main St, Mount Clemens, MI and can be reached out via phone at 586-468-1600 and via fax at 586-465-0329.

Location: 133 S Main St, Mount Clemens, MI, 60677-2464
person
Provider Profile Details
NPI Number
1073999629
Provider Name
Nicole Marie Shields
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
133 S Main St, Mount Clemens, MI, 60677-2464
Phone Number
586-468-1600
Fax Number
586-465-0329
Provider Enumeration Date
08/05/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5315080570 01 MI CONTROLLED SUBSTANCE LICENSE
5601007332 01 MI PHYSICIAN ASSISTANT LICENSE
institution
Provider Business Practice Location Address Details
Address
133 S Main St
City
State
Zip
48043-2308
Phone Number
586-468-1600
Fax Number
586-465-0329
person
Provider Business Mailing Address Details
Address
133 S Main St
City
State
Zip
48043-2308
Phone Number
586-468-1600
Fax Number
586-465-0329
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5601007332 (Michigan)
Definition
Definition to come...
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