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NPI Code Detail

MEDICARE: KELLY SHELTON CNP

MEDICARE: KELLY SHELTON 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.0027168OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730784059
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY SHELTON CNP
Provider Business Mailing Address
First Line : 909 RIDGEBROOK RD STE 300
Second Line :
City : SPARKS GLENCOE
State : MD
Zip : 21152-9477
Country : US
Telephone Number : 443-383-9300
Fax Number : 855-866-8710
Provider Business Practice Location Address
First Line : 200 PUBLIC SQ STE 2300
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2309
Country : US
Telephone Number : 443-383-9300
Fax Number : 855-866-8710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 03/28/2025

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Directions to “ KELLY SHELTON CNP” Practice Location

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