Provider Demographics
NPI:1851039408
Name:GOTCHER, SHELBY LANELL
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LANELL
Last Name:GOTCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 MCCAULLEY ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-2437
Mailing Address - Country:US
Mailing Address - Phone:325-236-1093
Mailing Address - Fax:
Practice Address - Street 1:1210 MCCAULLEY ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-2437
Practice Address - Country:US
Practice Address - Phone:325-236-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula