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Individual
TERRANCE SHELTON
Active
Individual
TERRANCE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP020662
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP020662
LICENSE
PA
Enumeration date
03/27/2020
Last updated
03/27/2020
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