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NPI Code Detail

MEDICARE: ANDREA BETHANY SHELLENBARGER CNP

MEDICARE:   ANDREA BETHANY SHELLENBARGER  CNP
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.022578OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP022578OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114280374OTHEROHFAMILY
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386162063
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA BETHANY SHELLENBARGER CNP
Provider Business Mailing Address
First Line : 06083 IOOF RD
Second Line :
City : SPENCERVILLE
State : OH
Zip : 45887-9373
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15145 LINCOLN HWY
Second Line :
City : VAN WERT
State : OH
Zip : 45891-9619
Country : US
Telephone Number : 419-313-3536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2017
Last Update Date : 01/11/2023

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