Individual
SHELBY COUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 S THOMPSON ST, FLAGSTAFF, AZ 86001-8759
(928) 226-6400
Mailing address
17374 E WOOLSEY WAY, RIO VERDE, AZ 85263-5357
(480) 748-0151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11184
AZ
Other
Enumeration date
06/17/2025
Last updated
07/22/2025
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