Provider Demographics
NPI:1588419980
Name:SHELTON, AZURE NOEL (APRN, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:AZURE
Middle Name:NOEL
Last Name:SHELTON
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 ARLO BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:PARKERS LAKE
Mailing Address - State:KY
Mailing Address - Zip Code:42634
Mailing Address - Country:US
Mailing Address - Phone:606-310-3911
Mailing Address - Fax:
Practice Address - Street 1:803 MEYERS BAKER RD STE 200
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-3040
Practice Address - Country:US
Practice Address - Phone:606-878-3240
Practice Address - Fax:606-878-4308
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1172231163WP0808X
KY4015289363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health