Provider Demographics
NPI:1477543387
Name:WOODLEY, SHELLEY B (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:B
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:B
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5207 HICKORY PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2624
Mailing Address - Country:US
Mailing Address - Phone:804-977-8938
Mailing Address - Fax:804-762-7102
Practice Address - Street 1:5207 HICKORY PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2624
Practice Address - Country:US
Practice Address - Phone:804-997-8938
Practice Address - Fax:804-762-7102
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166485363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN
VA010197562Medicaid
VA010197562Medicaid
MW1254591OtherDEA
VAC06778OtherGROUP PTAN
VA010197562Medicaid
VA016136V68Medicare PIN
VA016135V01Medicare PIN
VA007966C14Medicare ID - Type Unspecified