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General NPI Number Information
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NPI Number | 1639811326
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Entity Type | Individual
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Provider Name | SHELBY BRODIE HOOPER
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 726 N LOCUST AVE FL 1
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City | LAWRENCEBURG
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State | TN
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Zip | 38464-2865
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Country | US
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Telephone | 931-766-7056
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Fax |
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Provider Business Mailing Address
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Address Line | 30 STONEYBROOK CT
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City | LORETTO
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State | TN
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Zip | 38469-3265
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Country | US
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Telephone | 931-242-8597
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 3-000901
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License Number State | AL
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