Provider Demographics
NPI:1427870351
Name:HUFFSTUTLER, SHELLEE MARIE (CNA)
Entity type:Individual
Prefix:MS
First Name:SHELLEE
Middle Name:MARIE
Last Name:HUFFSTUTLER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34061 S RIVALS RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60481-9790
Mailing Address - Country:US
Mailing Address - Phone:217-495-3025
Mailing Address - Fax:
Practice Address - Street 1:34061 S RIVALS RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:IL
Practice Address - Zip Code:60481-9790
Practice Address - Country:US
Practice Address - Phone:217-495-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide