Provider Demographics
NPI:1730057712
Name:FRADY, SHELBY LYNN (NP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:FRADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7966 BOYLSTON HWY
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-8665
Mailing Address - Country:US
Mailing Address - Phone:828-702-6748
Mailing Address - Fax:
Practice Address - Street 1:89 W MILLS ST # A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-9450
Practice Address - Country:US
Practice Address - Phone:828-702-6748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program