Provider Demographics
NPI:1316353345
Name:TOMLIN, SHELLEY (FNP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 CRESTMONT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2017
Mailing Address - Country:US
Mailing Address - Phone:214-691-7837
Mailing Address - Fax:
Practice Address - Street 1:8611 HILLCREST AVE STE 180
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-4207
Practice Address - Country:US
Practice Address - Phone:214-368-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily