Sue Ellen Shives, RN
Individual provider Active NPI Registered Nurse · Clear Spring, MD
NPI 1972862704 · NPPES record last updated May 14, 2012
Key facts
- NPI
- 1972862704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R173386 (MD)
- Practice address
- 11902 Saint Paul Rd
Clear Spring, MD 21722-1946 - Phone
- (301) 842-2548
- NPI assigned
- May 14, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R173386 | MD | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R173386 | MD | Yes |
Addresses
Primary practice location
11902 Saint Paul Rd
Clear Spring, MD 21722-1946
Mailing address
11902 Saint Paul Rd
Clear Spring, MD 21722-1946
Phone (301) 842-2548
Other names
- Ms. Sue Ellen Fockler
Other providers in Clear Spring, MD
- Lauren Nicole Kessler
- Nicole Kreimer
- Anna Matullo-Miller
- Amy Norris
- Aimee Robinson
- Stay Home Senior Services Inc
- Jennifer Gay Taylor-Gray
- The Clear Spring Ambulance Club, Inc .
- Kathy Jean Thomspon
- Janelle Wilt
All providers in Clear Spring, MD · Registered Nurse in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.