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General NPI Number Information
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NPI Number | 1790848364
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Entity Type | Individual
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Provider Name | SANDRA D SHELLEY CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 3911 HIGHWAY 17 # B
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City | MURRELLS INLET
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State | SC
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Zip | 29576-5014
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Country | US
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Telephone | 843-651-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 4509 WOODLAND ST
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-5244
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 18465
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License Number State | SC
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