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SHELIA KERESA CHILDERS PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1558390658

Individual Registrant:
 SHELIA KERESA CHILDERS PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
100 GROSS CRESCENT CIR  FORT OGLETHORPE, GA 30742-3643 US
Tel: 706-858-2161  Fax: 865-560-7387

Contact information for business:
PO BOX 634909  CINCINNATI, OH 45263-6019 US
Tel: --  Fax: --

Registration Information:
NPI: 1558390658
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
GA003045

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
100002328DGA05
RAILROAD MEDICAREP00231570GA01
BCBS OF TENNESSEEP00231570TN01




HEALTH CARE JOBS GA - Page 1



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