Provider Demographics
NPI:1699366393
Name:HAYSLIP, SHELBY TYNDALL (PA-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:TYNDALL
Last Name:HAYSLIP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MASON
Other - Middle Name:SHELBY
Other - Last Name:TYNDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6213 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-7614
Mailing Address - Country:US
Mailing Address - Phone:919-398-4856
Mailing Address - Fax:
Practice Address - Street 1:2200 TREELIGHT WAY
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591
Practice Address - Country:US
Practice Address - Phone:919-374-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant