Provider Demographics
NPI:1548217300
Name:MCELHANON, SHELLEY (PA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:MCELHANON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8214
Mailing Address - Country:US
Mailing Address - Phone:704-661-8430
Mailing Address - Fax:
Practice Address - Street 1:10620 PARK RD
Practice Address - Street 2:SUITE 128
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8472
Practice Address - Country:US
Practice Address - Phone:704-542-6111
Practice Address - Fax:704-542-1239
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101765363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant