Provider Demographics
NPI:1902218985
Name:SHEMPERT, SHELLY (FNP)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:SHEMPERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6612 MAYNARDVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-4817
Mailing Address - Country:US
Mailing Address - Phone:865-688-1584
Mailing Address - Fax:865-688-1581
Practice Address - Street 1:6612 MAYNARDVILLE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-4817
Practice Address - Country:US
Practice Address - Phone:865-688-1584
Practice Address - Fax:865-688-1581
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000120213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily