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General NPI Number Information
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NPI Number | 1053102772
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Entity Type | Individual
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Provider Name | SHELBY TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 350 HERITAGE WAY STE 2100
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City | KALISPELL
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State | MT
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Zip | 59901-3167
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Country | US
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Telephone | 406-257-8992
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Fax | 406-257-8996
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Provider Business Mailing Address
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Address Line | 6419 GIRARD AVE
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City | CINCINNATI
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State | OH
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Zip | 45213-1223
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Country | US
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Telephone | 270-766-2490
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.0038481
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 266773
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License Number State | MT
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