MEDICARE: KAMERON LAYNE SHELLEY

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1306797774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMERON LAYNE SHELLEY

Provider Business Mailing Address
First Line	:	PO BOX 939
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-0939
Country	:	US
Telephone Number	:	402-630-1275
Fax Number	:

Provider Business Practice Location Address
First Line	:	5113 CUMING ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68132-2227
Country	:	US
Telephone Number	:	402-630-1275
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ KAMERON LAYNE SHELLEY ” Practice Location

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