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Individual

MS. SHELBY M WALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
600 GRESHAM DR FL 5, NORFOLK, VA 23507-1904
(757) 388-3198
(757) 388-4242
Mailing address
600 GRESHAM DR FL 5, NORFOLK, VA 23507-1904
(757) 388-3198
(757) 388-4242

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024175445
VA
363LA2200X
Adult Health Nurse Practitioner
Primary
0024175445
VA

Other

Enumeration date
09/28/2017
Last updated
02/06/2020
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