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General NPI Number Information
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NPI Number | 1265056774
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Entity Type | Individual
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Provider Name | NICOLE LATASHA SHELL PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/31/2020
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 5430 CAMPBELL BLVD STE 107
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City | WHITE MARSH
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State | MD
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Zip | 21162-5503
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Country | US
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Telephone | 443-720-3902
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Fax | 443-720-3916
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Provider Business Mailing Address
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Address Line | 1105 N POINT BLVD STE 310
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City | BALTIMORE
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State | MD
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Zip | 21224-3472
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Country | US
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Telephone | 410-800-6186
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Fax | 443-943-0027
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R192533
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License Number State | MD
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