Provider Demographics
NPI:1205599917
Name:SHELBY, VALERIE ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANN
Last Name:SHELBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 NIXON RD
Mailing Address - Street 2:
Mailing Address - City:LAVACA
Mailing Address - State:AR
Mailing Address - Zip Code:72941-3108
Mailing Address - Country:US
Mailing Address - Phone:479-461-0854
Mailing Address - Fax:
Practice Address - Street 1:2301 S 56TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3755
Practice Address - Country:US
Practice Address - Phone:479-461-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217303207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine