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General NPI Number Information
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NPI Number | 1033924873
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Entity Type | Individual
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Provider Name | SHELBY LOUISE TINNEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 100 S 10TH ST
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City | LILLINGTON
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State | NC
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Zip | 27546-6690
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Country | US
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Telephone | 910-893-4111
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Fax | 910-893-9850
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Provider Business Mailing Address
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Address Line | 739 ELDERBERRY DR
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City | VASS
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State | NC
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Zip | 28394-8444
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Country | US
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Telephone | 806-676-1094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5021639
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License Number State | NC
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