Provider Demographics
NPI:1518633940
Name:ALLEN, SHELBY STEWART (APRN)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:STEWART
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW SR 200 UNIT 400
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481
Mailing Address - Country:US
Mailing Address - Phone:352-861-1667
Mailing Address - Fax:352-861-1659
Practice Address - Street 1:8150 SW SR 200 UNIT 400
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481
Practice Address - Country:US
Practice Address - Phone:352-861-1667
Practice Address - Fax:352-861-1659
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014452363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner