Individual
SHELBY FALTYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1111 LIGHTHOUSE LN, GOSHEN, IN 46526-3824
(574) 533-8925
(574) 533-0277
Mailing address
1111 LIGHTHOUSE LANE, GOSHEN, IN 46526-3824
(574) 533-0348
(574) 533-0277
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28190483A
IN
363L00000X
Nurse Practitioner
Primary
71005391A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200817480
—
IN
Enumeration date
03/05/2015
Last updated
03/17/2018
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