Individual
SHELLEY BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4040 POSTAL DR, ROANOKE, VA 24018-6438
(540) 772-4453
Mailing address
3074 SEDGEFIELD RD SW, ROANOKE, VA 24015-4434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001-115896
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007788118
—
VA
Enumeration date
02/10/2006
Last updated
12/07/2020
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