Provider Demographics
NPI:1619137866
Name:SHELL, DEBORAH LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:SHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:SHELL
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:108 OAKWELL LN
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-7401
Mailing Address - Country:US
Mailing Address - Phone:423-753-3292
Mailing Address - Fax:
Practice Address - Street 1:108 OAKWELL LN
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-7401
Practice Address - Country:US
Practice Address - Phone:423-753-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse