Provider Demographics
NPI:1952645897
Name:PATTERSON, SHELBY (RN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14987 STATE ROUTE 81
Mailing Address - Street 2:
Mailing Address - City:VENEDOCIA
Mailing Address - State:OH
Mailing Address - Zip Code:45894-9634
Mailing Address - Country:US
Mailing Address - Phone:567-279-4050
Mailing Address - Fax:
Practice Address - Street 1:320 S BRANDON AVE
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-2015
Practice Address - Country:US
Practice Address - Phone:419-305-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28207262A163W00000X
OHRN.374496163W00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse