Provider Demographics
NPI:1851999437
Name:SORDEN, SHELLY ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:ANN
Last Name:SORDEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-2024
Mailing Address - Country:US
Mailing Address - Phone:417-876-2531
Mailing Address - Fax:417-876-3459
Practice Address - Street 1:400 E HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-2024
Practice Address - Country:US
Practice Address - Phone:417-876-2531
Practice Address - Fax:417-876-3459
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020034600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily