MEDICARE: SHELBY MULFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1043176225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY MULFORD

Provider Business Mailing Address
First Line	:	1800 W PASEWALK AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-5656
Country	:	US
Telephone Number	:	402-371-0220
Fax Number	:	402-644-4593

Provider Business Practice Location Address
First Line	:	1800 W PASEWALK AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-5656
Country	:	US
Telephone Number	:	402-371-0220
Fax Number	:	402-644-4593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “ SHELBY MULFORD ” Practice Location

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