Shanholtz, Kellie T

Shanholtz, Kellie T is an individual health care provider with primary practice located at 1840 Amherst St , Winchester VA 22601-2808. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Shanholtz, Kellie T can be contacted via phone (540) 536-8000.

Contact Information

Primary practice address
1840 Amherst St Winchester VA 22601-2808
Phone: (540) 536-8000
Fax: (540) 536-7681
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AC002767 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024134809 Virginia

Profile Details

NPI number 1659347524
LBN Legal business name Shanholtz, Kellie T
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Jul 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659347524 NPPES
West Virginia MEDICAID 2604151000

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