Provider Demographics
NPI:1447679139
Name:SHULTS, TEMPERANCE
Entity type:Individual
Prefix:
First Name:TEMPERANCE
Middle Name:
Last Name:SHULTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 BLUFF VIEW DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2568
Mailing Address - Country:US
Mailing Address - Phone:443-488-8098
Mailing Address - Fax:
Practice Address - Street 1:547 BLUFF VIEW DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2568
Practice Address - Country:US
Practice Address - Phone:443-488-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator