Healthcare Provider Details

I. General information

NPI: 1689285157
Provider Name (Legal Business Name): SHELBY NICOLE MAY-PARMLEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY NICOLE MAY OD

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 2ND ST NE
MINNEAPOLIS MN
55418-4306
US

IV. Provider business mailing address

5245 WAYZATA BLVD APT 310
ST LOUIS PARK MN
55416-1351
US

V. Phone/Fax

Practice location:
  • Phone: 901-289-2354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number3697
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: