Healthcare Provider Details

I. General information

NPI: 1255147641
Provider Name (Legal Business Name): SHELBY ELMORE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8895 N MILITARY TRL STE 306-E
PALM BEACH GARDENS FL
33410
US

IV. Provider business mailing address

1859 RIDGE RD APT 1
N PALM BEACH FL
33408
US

V. Phone/Fax

Practice location:
  • Phone: 561-531-7818
  • Fax:
Mailing address:
  • Phone: 561-315-7175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberRN9673751
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: