Wilson, Shalise Tina
Wilson, Shalise Tina is an sole proprietor health care provider with primary practice located at 245 E 680 S , Cedar City UT 84720-3593. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Wilson, Shalise Tina can be contacted via phone (435) 867-7654.Contact Information
Primary practice address
245 E 680 S
Cedar City UT 84720-3593
Phone: (435) 867-7654
Fax: (435) 867-7699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1700391182 |
|---|---|
| LBN Legal business name | Wilson, Shalise Tina |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 7th, 2017 |
| Last updated | May 9th, 2024 - about 7 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700391182 | NPPES |
| Utah | Other | 1741000189085 | PEHP |
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