Individual
MR. MICHAEL TYSHUNE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN
Contact information
Practice address
829 GOETHALS DR, RICHLAND, WA 99352-3529
(509) 547-2204
(509) 542-8836
Mailing address
3750 COMMERCIAL AVE, SAN ANTONIO, TX 78221-3117
(210) 922-7000
(210) 227-0282
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 794786
TX
363L00000X
Nurse Practitioner
AP61096750
WA
363LF0000X
Family Nurse Practitioner
AP61096750
WA
363LF0000X
Family Nurse Practitioner
Primary
F1009375 NP-C
TX
Other
Enumeration date
08/25/2009
Last updated
11/15/2024
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