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1568083426
SHALETTA NUCKOLLS
WEST BLOOMFIELD, MI
NPI
1568083426
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601009964)
Enumeration Date
2020-05-02
Last Update Date
2024-03-07
Business Address
SHALETTA NUCKOLLS PA-C
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322-3013
Phone number: 248-325-1000
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Mailing Address
SHALETTA NUCKOLLS PA-C
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322-3013
Phone number: 313-492-0080
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