Healthcare Provider Details

I. General information

NPI: 1922918325
Provider Name (Legal Business Name): SHELBY KILLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 WEBBS LN
DOVER DE
19904-5438
US

IV. Provider business mailing address

360 WEBBS LN
DOVER DE
19904-5438
US

V. Phone/Fax

Practice location:
  • Phone: 302-632-6936
  • Fax:
Mailing address:
  • Phone: 302-632-6936
  • Fax: 302-697-4973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberL1-0048650
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: