Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shaletta Nuckolls, PA-C

Individual provider Physician Assistant · NPI 1568083426

Shaletta Nuckolls, PA-C is a Physician Assistant in Ann Arbor, Michigan. Qualified in 2020, 6 years ago. Practices with Henry Ford Health System, a 2,540-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone: (734) 936-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6777 W Maple Rd, West Bloomfield, MI 48322-3013 — (248) 325-1000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601009964 (MI)

Record details

NPI number1568083426
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 2, 2020
Last updated in NPPESJuly 10, 2026
Certification dateJuly 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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