1043849110 NPI number — ORIANNIE SHELTON DNP

Table of content: ORIANNIE SHELTON DNP (NPI 1043849110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043849110 NPI number — ORIANNIE SHELTON DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHELTON
Provider First Name:
ORIANNIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALOMON
Provider Other First Name:
ORIANNIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043849110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
936 BARCARMIL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34110-0903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-265-3391
Provider Business Mailing Address Fax Number:
239-310-2035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
936 BARCARMIL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34110-0903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-265-3391
Provider Business Practice Location Address Fax Number:
239-310-2035
Provider Enumeration Date:
04/02/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  APRN11020045 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LC1500X , with the licence number: APRN11020045 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)