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General NPI Number Information
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NPI Number | 1447077433
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Entity Type | Individual
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Provider Name | SHELBY ALEXANDRA PRATER
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 38 WOODCROFT TRL
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City | BEAVERCREEK
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State | OH
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Zip | 45430-1980
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Country | US
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Telephone | 937-427-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 614 LOUISE DR
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City | XENIA
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State | OH
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Zip | 45385-1703
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Country | US
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Telephone |
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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 | APRN.CNP.0037608
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License Number State | OH
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