MEDICARE: DR. SHELLEY WILLIS NESBITT PHARM.D.

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	183500000X	Pharmacist	PS 32861	FL
2	1835N1003X	Nutrition Support Pharmacist	PS 32861	FL
3	1835P1200X	Pharmacotherapy Pharmacist	PS 32861	FL

General Provider Information

NPI Number	:	1346242039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLEY WILLIS NESBITT PHARM.D.

Provider Business Mailing Address
First Line	:	104 RIDGEWOOD AVE
Second Line	:
City	:	CLEWISTON
State	:	FL
Zip	:	33440-5114
Country	:	US
Telephone Number	:	863-983-0389
Fax Number	:	561-996-6608

Provider Business Practice Location Address
First Line	:	1201 S MAIN ST
Second Line	:
City	:	BELLE GLADE
State	:	FL
Zip	:	33430-4911
Country	:	US
Telephone Number	:	561-996-6571
Fax Number	:	561-996-6608

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	09/11/2025

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