Provider Demographics
NPI:1629442348
Name:CHESSHIR, SHELBY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:
Last Name:CHESSHIR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LAFAYETTE 2032
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:AR
Mailing Address - Zip Code:71861-8835
Mailing Address - Country:US
Mailing Address - Phone:870-904-4568
Mailing Address - Fax:
Practice Address - Street 1:27 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-3241
Practice Address - Country:US
Practice Address - Phone:318-539-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021098183500000X
ARPD13242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist