Provider Demographics
NPI:1497245732
Name:SHELTON, ELIZABETH ANN (BSN RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:MRS
Other - First Name:BETH ANN
Other - Middle Name:ANN
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN RN
Mailing Address - Street 1:15121 SADDLE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-1003
Mailing Address - Country:US
Mailing Address - Phone:817-874-8222
Mailing Address - Fax:
Practice Address - Street 1:15121 SADDLE RIDGE CIR
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-1003
Practice Address - Country:US
Practice Address - Phone:817-874-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX851512163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care