Provider Demographics
NPI:1073175386
Name:SHELTON, BETTINA N (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BETTINA
Middle Name:N
Last Name:SHELTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 TWEED SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-2308
Mailing Address - Country:US
Mailing Address - Phone:423-525-2275
Mailing Address - Fax:
Practice Address - Street 1:101 MED TECH PKWY STE 100
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4006
Practice Address - Country:US
Practice Address - Phone:423-794-1800
Practice Address - Fax:423-794-1801
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily