Provider Demographics
NPI:1750688040
Name:HORTON, SHELLEY NKECHI (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:NKECHI
Last Name:HORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SHELLEY
Other - Middle Name:N
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3535 S WILMINGTON ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3562
Mailing Address - Country:US
Mailing Address - Phone:919-633-8202
Mailing Address - Fax:919-287-2222
Practice Address - Street 1:3535 S WILMINGTON ST
Practice Address - Street 2:SUITE 105
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3562
Practice Address - Country:US
Practice Address - Phone:919-633-8202
Practice Address - Fax:919-287-2222
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4303251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health