Provider Demographics
NPI:1790921492
Name:FALCONE, SHELLEY F (CRNA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:F
Last Name:FALCONE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17613 SPINNAKERS REACH DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7591
Mailing Address - Country:US
Mailing Address - Phone:704-450-1627
Mailing Address - Fax:
Practice Address - Street 1:17613 SPINNAKERS REACH DR
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-7591
Practice Address - Country:US
Practice Address - Phone:704-450-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80420367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered