Provider Demographics
NPI:1356850796
Name:MILLWOOD, SHELBY (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:MILLWOOD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-9543
Mailing Address - Country:US
Mailing Address - Phone:704-434-6560
Mailing Address - Fax:
Practice Address - Street 1:105 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-9543
Practice Address - Country:US
Practice Address - Phone:704-434-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC194737363LF0000X
NC5009911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily