Individual
SHELBY FORNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-2143
(317) 944-3107
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
28236497A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71010070B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300038711
—
IN
Enumeration date
11/14/2019
Last updated
07/22/2021
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