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Individual

AMANDA L SHELBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
915 POQUONNOCK RD, GROTON, CT 06340-4257
(860) 446-0144
Mailing address
110 OLD KENT RD N, TOLLAND, CT 06084-3328

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
137290
CT
163W00000X
Registered Nurse
RN2309851
MA
363LF0000X
Family Nurse Practitioner
Primary
9210
CT

Other

Enumeration date
10/30/2020
Last updated
12/10/2020
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