Provider Demographics
NPI:1790480028
Name:WILKENING, SHELBEY LAURYN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHELBEY
Middle Name:LAURYN
Last Name:WILKENING
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2022
Mailing Address - Country:US
Mailing Address - Phone:417-256-2111
Mailing Address - Fax:417-256-4858
Practice Address - Street 1:805 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2022
Practice Address - Country:US
Practice Address - Phone:417-256-2111
Practice Address - Fax:417-256-4858
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF03230169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily