Individual
SHELLY BARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11143 PARKVIEW PLAZA DR STE 207, FORT WAYNE, IN 46845-1728
(260) 425-6330
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28161212A
IN
363L00000X
Nurse Practitioner
Primary
71007629A
IN
Other
Enumeration date
10/04/2017
Last updated
10/07/2022
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