Provider Demographics
NPI:1396343992
Name:BOWERLY, SHELBY TAYLOR (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:TAYLOR
Last Name:BOWERLY
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:TAYLOR
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65371 HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-8690
Mailing Address - Country:US
Mailing Address - Phone:509-493-2133
Mailing Address - Fax:
Practice Address - Street 1:65371 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8690
Practice Address - Country:US
Practice Address - Phone:509-493-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10014247363LP2300X
WA61478070363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care