Provider Demographics
NPI:1023717832
Name:CALDWELL, SHELBY (RN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 MONNING LN
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-2322
Mailing Address - Country:US
Mailing Address - Phone:214-799-7200
Mailing Address - Fax:
Practice Address - Street 1:3900 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75799-6600
Practice Address - Country:US
Practice Address - Phone:903-566-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX923163163W00000X
TX1203062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse