Provider Information for 1366799967
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
KELLY J. SHELTON LCSW
Sex: Female
NPI: 1366799967
Last Updated: 2013-01-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366799967 | ||||||||
| Enumeration Date | 2012-08-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 105 JAZZ DR PANAMA CITY, FL 32405-4906 United States Phone: 850-522-9719 | Fax: | ||||||||
| Primary Practice Address | 105 JAZZ DR PANAMA CITY, FL 32405-4906 United States Phone: 850-522-9719 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|