Shields, Karissa V
Shields, Karissa V is an individual health care provider with primary practice located at 111 Otis Smith Dr , Clarksville TN 37043-8940. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Shields, Karissa V can be contacted via phone (931) 553-6666.Contact Information
Primary practice address
111 Otis Smith Dr
Clarksville TN 37043-8940
Phone: (931) 553-6666
Fax: (931) 553-6681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA1586 | Nevada |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 6144 | Tennessee |
Profile Details
| NPI number | 1467843011 |
|---|---|
| LBN Legal business name | Shields, Karissa V |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2015 |
| Last updated | Oct 7th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467843011 | NPPES |
| Nevada | MEDICAID | 100504311 |
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