Provider Demographics
NPI:1649684622
Name:SHELTON MOON, JULIE ELIZABETH (DO)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELIZABETH
Last Name:SHELTON MOON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-4088
Mailing Address - Fax:
Practice Address - Street 1:1222 TROTWOOD AVE STE 211
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6405
Practice Address - Country:US
Practice Address - Phone:931-777-2300
Practice Address - Fax:931-777-2301
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3619207R00000X
GA88441207RC0000X
TN6011207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease