MEDICARE: SHELBY GILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	RN258729	GA

General Provider Information

NPI Number	:	1194491506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY GILES

Provider Business Mailing Address
First Line	:	4300 N POINT PKWY STE 300
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 OLD HIGHWAY 96 STE B
Second Line	:
City	:	BONAIRE
State	:	GA
Zip	:	31005-3461
Country	:	US
Telephone Number	:	478-352-7143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	06/19/2025

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Directions to “ SHELBY GILES ” Practice Location

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