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General NPI Number Information
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NPI Number | 1619212479
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Entity Type | Individual
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Provider Name | JANET L SHELLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 950 E BOGARD RD SUITE 233
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City | WASILLA
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State | AK
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Zip | 99654-7184
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Country | US
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Telephone | 907-357-4543
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 940444
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City | HOUSTON
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State | AK
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Zip | 99694-0444
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Country | US
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Telephone | 907-892-0225
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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 | 1325
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License Number State | AK
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