=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386355931
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER MICHELE SHELTON APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2022
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 ESTILL ST FL 4
-----------------------------------------------------
City | BEREA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40403-1909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-983-2343
-----------------------------------------------------
Fax | 859-986-2344
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 936
-----------------------------------------------------
City | LONDON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40743-0936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-330-7835
-----------------------------------------------------
Fax | 859-986-2344
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 3018401
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 1147539
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------