Provider Demographics
NPI:1003880873
Name:SHELTON, SUSAN (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:1881 PISGAH DR
Practice Address - Street 2:BUILDING A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3760
Practice Address - Country:US
Practice Address - Phone:828-697-4336
Practice Address - Fax:828-694-6757
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00323356OtherMEDICARE RAILROAD
NC157AEOtherBCBS NC
NC157AEOtherBCBS NC
S40320Medicare UPIN