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Individual
SHELBY JORDAN SUBRY
Active
Individual
SHELBY JORDAN SUBRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-16799
NC
363AM0700X
Medical Physician Assistant
PA.0006160
CO
363AM0700X
Medical Physician Assistant
PA216320
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500824302
—
OR
Enumeration date
06/26/2019
Last updated
08/26/2026
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