Healthcare Provider Details

I. General information

NPI: 1073224077
Provider Name (Legal Business Name): SHELBY BEERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 SULLIVAN AVE
CIRCLE MT
59215-7514
US

IV. Provider business mailing address

605 SULLIVAN AVE
CIRCLE MT
59215-7514
US

V. Phone/Fax

Practice location:
  • Phone: 406-485-2063
  • Fax:
Mailing address:
  • Phone: 406-485-2063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-265874
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: