Provider Demographics
NPI:1821825548
Name:SOUSA, SHELBY LYNN
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:SOUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CHERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-2211
Mailing Address - Country:US
Mailing Address - Phone:508-915-1954
Mailing Address - Fax:
Practice Address - Street 1:58 CHERRY HILL DR
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-2211
Practice Address - Country:US
Practice Address - Phone:508-915-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula