Provider Demographics
NPI:1952175309
Name:FREES, SHELBI T (APRN)
Entity Type:Individual
Prefix:
First Name:SHELBI
Middle Name:T
Last Name:FREES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHELBI
Other - Middle Name:T
Other - Last Name:FREES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:611 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:67526-1440
Mailing Address - Country:US
Mailing Address - Phone:620-564-3771
Mailing Address - Fax:620-564-2491
Practice Address - Street 1:611 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLINWOOD
Practice Address - State:KS
Practice Address - Zip Code:67526-1440
Practice Address - Country:US
Practice Address - Phone:620-564-3771
Practice Address - Fax:620-564-2491
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily