Individual
JAIMIE LEANNE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
245 MEDICAL PARK DR, SUITE C, MARION, VA 24354-1100
(276) 378-3300
(276) 378-1265
Mailing address
245 MEDICAL PARK DR, SUITE C, MARION, VA 24354-1100
(276) 378-3300
(276) 378-1265
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-004707
VA
363A00000X
Physician Assistant
PA0000002664
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285022095
—
VA
Enumeration date
12/31/2014
Last updated
02/27/2017
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