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Individual
SHELLY A WEATHERFORD
Active
Individual
SHELLY A WEATHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08556
TX
363A00000X
Physician Assistant
PA2011-0048
NM
Other
Enumeration date
10/26/2011
Last updated
05/04/2015
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