Provider Demographics
NPI:1154915346
Name:SHELLER, JAMES THOMAS (ACNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:SHELLER
Suffix:
Gender:M
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1727
Mailing Address - Street 2:
Mailing Address - City:GRAND JCT
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1727
Mailing Address - Country:US
Mailing Address - Phone:970-644-4030
Mailing Address - Fax:970-644-3914
Practice Address - Street 1:2503 FORESIGHT CIR UNIT B
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1139
Practice Address - Country:US
Practice Address - Phone:906-644-4030
Practice Address - Fax:970-644-3914
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996101-NP363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care