Provider Demographics
NPI:1346242039
Name:NESBITT, SHELLEY WILLIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:WILLIS
Last Name:NESBITT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-5114
Mailing Address - Country:US
Mailing Address - Phone:863-983-0389
Mailing Address - Fax:561-996-6608
Practice Address - Street 1:1201 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-4911
Practice Address - Country:US
Practice Address - Phone:561-996-6571
Practice Address - Fax:561-996-6608
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 32861183500000X, 1835N1003X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy