Provider Demographics
NPI:1194206474
Name:MURLEY, SHELBY TAYLOR (OTR/L OTD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:TAYLOR
Last Name:MURLEY
Suffix:
Gender:F
Credentials:OTR/L OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12424 S 217TH ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-5994
Mailing Address - Country:US
Mailing Address - Phone:319-215-6519
Mailing Address - Fax:
Practice Address - Street 1:323 S 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2106
Practice Address - Country:US
Practice Address - Phone:402-330-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist