Provider Demographics
NPI:1659637874
Name:NEWMAN, SHELLEY L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:L
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1347
Mailing Address - Country:US
Mailing Address - Phone:157-921-9116
Mailing Address - Fax:615-792-0603
Practice Address - Street 1:313 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1347
Practice Address - Country:US
Practice Address - Phone:157-921-9116
Practice Address - Fax:615-792-0603
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN185923163W00000X
TN26851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse