Shields, Nicole Paulson

Shields, Nicole Paulson is an individual health care provider with primary practice located at 424 N Broad St , New Tazewell TN 37825-6606. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Shields, Nicole Paulson can be contacted via phone (423) 869-7193.

Contact Information

Primary practice address
424 N Broad St New Tazewell TN 37825-6606
Fax: (423) 869-7195
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2009-01338 North Carolina

Profile Details

NPI number 1992979454
LBN Legal business name Shields, Nicole Paulson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2008
Last updated Nov 23rd, 2020 - 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 1992979454 NPPES
Tennessee MEDICAID Q000615

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