Provider Demographics
NPI:1487031456
Name:SHELLEY, ELIZABETH ANN (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SHELLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5529 ROSECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1819
Mailing Address - Country:US
Mailing Address - Phone:440-600-1002
Mailing Address - Fax:440-209-5747
Practice Address - Street 1:5529 ROSECLIFF DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1819
Practice Address - Country:US
Practice Address - Phone:440-600-1002
Practice Address - Fax:440-209-5747
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1348982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry