Provider Demographics
NPI:1932389590
Name:SHELTON, SHERYL LYNN (ARNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:LYNN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:110 3RD ST
Mailing Address - Street 2:STE 180
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-5808
Mailing Address - Country:US
Mailing Address - Phone:270-827-3573
Mailing Address - Fax:270-827-1250
Practice Address - Street 1:110 3RD ST
Practice Address - Street 2:SUITE 180
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2993
Practice Address - Country:US
Practice Address - Phone:270-827-3573
Practice Address - Fax:270-827-1250
Is Sole Proprietor?:No
Enumeration Date:2007-11-11
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005345363L00000X, 363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100031240Medicaid