Individual
OMA L SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2230 S SPRINGFIELD AVE, SUITE H-J, BOLIVAR, MO 65613-9133
(417) 777-4800
Mailing address
P.O. BOX 939, BOLIVAR, MO 65613-0939
(417) 777-4800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
080074
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083679104
—
MO
Enumeration date
04/20/2006
Last updated
07/02/2013
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