Provider Demographics
NPI:1316613888
Name:OESCH, SHELLI SUZANNE (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:SHELLI
Middle Name:SUZANNE
Last Name:OESCH
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 W GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1700
Mailing Address - Country:US
Mailing Address - Phone:269-945-7497
Mailing Address - Fax:269-945-0214
Practice Address - Street 1:1375 W GREEN ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1700
Practice Address - Country:US
Practice Address - Phone:269-945-7497
Practice Address - Fax:269-945-0214
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270969363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health