Provider Demographics
NPI:1881331783
Name:HARRY, SHELBY (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:
Last Name:HARRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:SHELBY
Other - Middle Name:ALLEN
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:502 E GOODE ST STE 1E
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783-2539
Mailing Address - Country:US
Mailing Address - Phone:903-763-5402
Mailing Address - Fax:
Practice Address - Street 1:502 E GOODE ST # 1E
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2539
Practice Address - Country:US
Practice Address - Phone:903-763-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078219363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner