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Individual
SHELLY C BRAY
Active
Individual
SHELLY C BRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-4195
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06080018100
QUALCHOICE
AR
05
—
155215001
—
AR
01
—
7373851
AETNA
AR
01
—
762691
HEALTHLINK
AR
Enumeration date
07/17/2006
Last updated
01/24/2020
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