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General NPI Number Information
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NPI Number | 1285190892
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Entity Type | Individual
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Provider Name | SHELBY NICOLE WILMES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 2560 W ELK AVE
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City | DUNCAN
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State | OK
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Zip | 73533-1562
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Country | US
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Telephone | 802-529-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 8214 HORSETAIL CT
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City | CONROE
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State | TX
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Zip | 77385-1102
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Country | US
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Telephone | 405-779-6371
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP139341
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License Number State | TX
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