Kelly Shields | Austin, TX • PECOS Search

Kelly Shields

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1301 W 38th St, Austin, TX 78705-1000

(512) 681-0500 (216) 288-7672

PECOS Enrollment

Based on the most recent information from CMS, provider Kelly Shields does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1417215773
Provider Type
Individual
Full Name
Shields, Kelly
Title
Dr.
Credential
DNP, FNP-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/24/2012
Last Updated
10/22/2013

Contact Information

Practice Location

1301 W 38th St, Austin, TX 78705-1000

Unlisted Fax

Mailing Location

3643 Pine Needle Cir, Round Rock, TX 78681-2361

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License COA.13191-NP Ohio