Healthcare Provider Details

I. General information

NPI: 1225845753
Provider Name (Legal Business Name): JOSEPH SHELTON NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

26020 PEAR ORCHARD RD
MOSELEY VA
23120-1303
US

V. Phone/Fax

Practice location:
  • Phone: 804-483-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0001239297
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024192049
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: