Provider Demographics
NPI:1649525601
Name:SHELTON, RACHEL ANNE RILEY (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE RILEY
Last Name:SHELTON
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 1:3212 JOHN MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1371
Mailing Address - Country:US
Mailing Address - Phone:703-241-0891
Mailing Address - Fax:
Practice Address - Street 1:3263 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4351
Practice Address - Country:US
Practice Address - Phone:703-746-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily