Provider Demographics
NPI:1912544701
Name:WEBER, SHELBY MORGAN (CRNP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:MORGAN
Last Name:WEBER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8489 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:AL
Mailing Address - Zip Code:35116-1118
Mailing Address - Country:US
Mailing Address - Phone:850-375-4518
Mailing Address - Fax:
Practice Address - Street 1:1960 GADSDEN HWY STE 108
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-4201
Practice Address - Country:US
Practice Address - Phone:205-655-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily