Individual
MS. FALLON PAGE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3912 W BAY VILLA AVE, TAMPA, FL 33611-1222
(727) 249-7676
(833) 500-1422
Mailing address
2553 MASON OAKS DR, VALRICO, FL 33596-6498
(813) 940-6046
(866) 451-4607
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11023017
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116748700
—
FL
Enumeration date
11/22/2022
Last updated
11/02/2023
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