Individual
MS. ELIZABETH BERNADETTE SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP, RN
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
(718) 299-6797
Mailing address
1434 WILLIAMSBRIDGE RD FL 2, BRONX, NY 10461-2507
(718) 618-0401
(347) 479-1303
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
652493
NY
363LF0000X
Family Nurse Practitioner
Primary
F339329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04103251
—
NY
Enumeration date
09/04/2012
Last updated
03/16/2021
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