Shelton, Jacques L

Shelton, Jacques L is an individual health care provider with primary practice located at 234 Goodman St Anesthesia Intensive Care Consultants Inc, Cincinnati OH 45219-2364. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Shelton, Jacques L can be contacted via phone (513) 558-4194.

Contact Information

Primary practice address
234 Goodman St Anesthesia Intensive Care Consultants Inc Cincinnati OH 45219-2364
Phone: (513) 558-4194
Fax: (513) 558-0995
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN.166462-COA1 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X COA.00847-NA Ohio

Profile Details

NPI number 1467437772
LBN Legal business name Shelton, Jacques L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Jun 5th, 2017 - about 7 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 1467437772 NPPES
Kentucky Other 617610 WELLCARE
Kentucky MEDICAID 74369539 WELLCARE
Kentucky Other 000000277560 WELLCARE
Kentucky MEDICAID 0738778 WELLCARE
Kentucky MEDICAID 100388250 WELLCARE
Kentucky Other 728035 WELLCARE

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