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General NPI Number Information
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NPI Number | 1255568523
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Entity Type | Individual
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Provider Name | SHELLY MARIE OLES DNP, ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 9225 BAY PLAZA BLVD STE 417
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City | TAMPA
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State | FL
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Zip | 33619-4412
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Country | US
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Telephone | 810-354-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 202 W SHIAWASSEE AVE STE 107
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City | FENTON
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State | MI
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Zip | 48430-2093
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Country | US
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Telephone | 810-354-8100
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Fax | 810-354-8012
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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 | 4704229825
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License Number State | MI
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