Provider Demographics
NPI:1962793729
Name:SHELOR, NATHALIE MIRIAM (CPNP)
Entity type:Individual
Prefix:MISS
First Name:NATHALIE
Middle Name:MIRIAM
Last Name:SHELOR
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:6830 HOSPITAL DR
Mailing Address - Street 2:SUITE #206
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4373
Mailing Address - Country:US
Mailing Address - Phone:410-238-5390
Mailing Address - Fax:410-238-5396
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE 206
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4373
Practice Address - Country:US
Practice Address - Phone:410-238-5390
Practice Address - Fax:410-238-5396
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2017-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR194676363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics