Individual
CANDI DENISE SHELBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
853 JEFFERSON AVE # E206, MEMPHIS, TN 38103-2804
(901) 448-6728
Mailing address
1117 HOUSTON ST, TUPELO, MS 38804-2519
(662) 643-6377
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
25868
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25868
—
TN
Enumeration date
05/21/2019
Last updated
05/21/2019
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