Healthcare Provider Details

I. General information

NPI: 1982304374
Provider Name (Legal Business Name): SHELBY ALEICE DAY DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 ALPHA LN
HIXSON TN
37343-4054
US

IV. Provider business mailing address

16740 RANKIN AVE
DUNLAP TN
37327-7023
US

V. Phone/Fax

Practice location:
  • Phone: 423-870-1662
  • Fax:
Mailing address:
  • Phone: 423-870-1662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33511
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: