Provider Demographics
NPI:1407581333
Name:BILLEAUD, SHELBY NICOLE (CNP)
Entity Type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:NICOLE
Last Name:BILLEAUD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 INGLESIDE AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3032
Mailing Address - Country:US
Mailing Address - Phone:614-564-7074
Mailing Address - Fax:
Practice Address - Street 1:2880 STELZER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3133
Practice Address - Country:US
Practice Address - Phone:614-472-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily