Individual
SHELLY R. FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6158
Mailing address
PO BOX 634909, CINCINNATI, OH 45263-4909
(423) 488-8180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN165285
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788587805A
—
GA
01
—
P00427532
RAILROAD MEDICARE
GA
Enumeration date
02/28/2007
Last updated
05/03/2011
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