Provider Demographics
NPI:1871982876
Name:SHULEVA, MIRELA (FNP-C)
Entity type:Individual
Prefix:
First Name:MIRELA
Middle Name:
Last Name:SHULEVA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 CENTRAL ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-5750
Mailing Address - Country:US
Mailing Address - Phone:773-983-6493
Mailing Address - Fax:
Practice Address - Street 1:2221 CENTRAL ST APT 3E
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5750
Practice Address - Country:US
Practice Address - Phone:773-983-6493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily