Healthcare Provider Details

I. General information

NPI: 1073469144
Provider Name (Legal Business Name): SHELBY HARDING CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15901 BASS RD STE 100
FORT MYERS FL
33908-3838
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-7130
  • Fax: 239-343-7185
Mailing address:
  • Phone: 239-343-7130
  • Fax: 239-343-7185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11046492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: