Provider Demographics
NPI:1447792627
Name:SHELL, EMILY (CNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SHELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:CALKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:262 SIDNEY ST
Mailing Address - Street 2:APT 1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4848
Mailing Address - Country:US
Mailing Address - Phone:802-309-4054
Mailing Address - Fax:
Practice Address - Street 1:780 ALBANY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2524
Practice Address - Country:US
Practice Address - Phone:857-654-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-05
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN270053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily