Provider Demographics
NPI:1083004022
Name:SHELTON, CHRISTINA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
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 1:1151 COUNTY ROAD 197
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38828-9142
Mailing Address - Country:US
Mailing Address - Phone:662-538-9992
Mailing Address - Fax:662-538-9992
Practice Address - Street 1:1151 COUNTY ROAD 197
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38828-9142
Practice Address - Country:US
Practice Address - Phone:662-538-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR88820363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily