MEDICARE: DR. SHELLY LYN SCOTT ADKINS RN

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	163WC0400X	Case Management Registered Nurse	26NO09967400	NJ
2	163WC0400X	Case Management Registered Nurse	RN334754L	PA

General Provider Information

NPI Number	:	1598108920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLY LYN SCOTT ADKINS RN

Provider Business Mailing Address
First Line	:	404 FRANKFORD AVE
Second Line	:
City	:	BLACKWOOD
State	:	NJ
Zip	:	08012-4534
Country	:	US
Telephone Number	:	856-209-9468
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-4107
Country	:	US
Telephone Number	:	--
Fax Number	:

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

Provider Enumeration Date	:	04/16/2013
Last Update Date	:	06/09/2023

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