Provider Demographics
NPI:1588955934
Name:CRISLER, SHELLY L (CRNP)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:L
Last Name:CRISLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:DYAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:295 STONER AVE
Mailing Address - Street 2:STE 305
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5646
Mailing Address - Country:US
Mailing Address - Phone:410-848-7117
Mailing Address - Fax:410-857-8575
Practice Address - Street 1:295 STONER AVE
Practice Address - Street 2:STE 305
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5646
Practice Address - Country:US
Practice Address - Phone:410-848-7117
Practice Address - Fax:410-857-8575
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170664363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner