Provider Demographics
NPI:1235533688
Name:STOREY, SHELLENA (NP)
Entity Type:Individual
Prefix:
First Name:SHELLENA
Middle Name:
Last Name:STOREY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W END AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2526
Mailing Address - Country:US
Mailing Address - Phone:615-695-2141
Mailing Address - Fax:615-321-2721
Practice Address - Street 1:1801 W END AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2526
Practice Address - Country:US
Practice Address - Phone:615-695-2141
Practice Address - Fax:615-321-2721
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13963363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology