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General NPI Number Information
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NPI Number | 1750187373
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Entity Type | Individual
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Provider Name | SHELA FOBELLAH
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 145 MORRIS RD
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1363
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Country | US
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Telephone | 740-474-8874
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6179
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-6179
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0037473
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License Number State | OH
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