Provider Demographics
NPI:1003650839
Name:FORD, SHELBIE LYNNE (PA)
Entity type:Individual
Prefix:
First Name:SHELBIE
Middle Name:LYNNE
Last Name:FORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4512 MEADOWDALE ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4134
Mailing Address - Country:US
Mailing Address - Phone:504-606-3531
Mailing Address - Fax:
Practice Address - Street 1:17000 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3246
Practice Address - Country:US
Practice Address - Phone:225-755-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant