Provider Demographics
NPI:1447755772
Name:SHELL, CATHY (NP)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:SHELL
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 1:98 WHEATFIELD LN
Mailing Address - Street 2:
Mailing Address - City:STAR TANNERY
Mailing Address - State:VA
Mailing Address - Zip Code:22654-3167
Mailing Address - Country:US
Mailing Address - Phone:540-335-6730
Mailing Address - Fax:
Practice Address - Street 1:98 WHEATFIELD LN
Practice Address - Street 2:
Practice Address - City:STAR TANNERY
Practice Address - State:VA
Practice Address - Zip Code:22654-3167
Practice Address - Country:US
Practice Address - Phone:540-335-6730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001215908163WH0200X
VA0024180851363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner