Provider Demographics
NPI:1437938263
Name:SHADRICK, SHELBY RENEE (MSN, APRN, WHNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:RENEE
Last Name:SHADRICK
Suffix:
Gender:F
Credentials:MSN, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 N SHORE DR APT 304
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8475
Mailing Address - Country:US
Mailing Address - Phone:317-750-6865
Mailing Address - Fax:
Practice Address - Street 1:2314 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2802
Practice Address - Country:US
Practice Address - Phone:513-287-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034949363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health