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General NPI Number Information
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NPI Number | 1629696901
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Entity Type | Individual
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Provider Name | SHELBY MILBURN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 1955 FESTIVAL PLAZA DR STE 180
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City | LAS VEGAS
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State | NV
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Zip | 89135-3064
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Country | US
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Telephone | 702-778-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 7332 BANNEKER PARK ST
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City | LAS VEGAS
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State | NV
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Zip | 89166-6036
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Country | US
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Telephone | 805-260-5853
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 832166
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License Number State | NV
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