Provider Demographics
NPI:1487437562
Name:SHIVES, KARLI JOSEPHINE (MSPAS)
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:JOSEPHINE
Last Name:SHIVES
Suffix:
Gender:F
Credentials:MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:OH
Mailing Address - Zip Code:44672-1643
Mailing Address - Country:US
Mailing Address - Phone:330-537-4661
Mailing Address - Fax:330-537-4482
Practice Address - Street 1:605 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:OH
Practice Address - Zip Code:44672-1643
Practice Address - Country:US
Practice Address - Phone:330-537-4661
Practice Address - Fax:330-537-4482
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008421RX207P00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine