Individual
SHELLY MAE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 774-9106
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 774-9106
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
119027
MO
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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