Provider Demographics
NPI:1508511064
Name:FURNER, SHELEENA RENEE (AGPCNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHELEENA
Middle Name:RENEE
Last Name:FURNER
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:SHELEENA
Other - Middle Name:RENEE
Other - Last Name:FURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 MOORE RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8703
Practice Address - Country:US
Practice Address - Phone:336-983-4346
Practice Address - Fax:336-985-5101
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015777363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner