MS. ELIZABETH BERNADETTE SHELLEY MSN FNP RN NPI 1073862207

NPI Information

NPI: 1073862207
Provider Name: MS. ELIZABETH BERNADETTE SHELLEY, MSN, FNP, RN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2015 GRAND CONCOURSE
BRONX, NY
ZIP 10453
Phone: (718) 299-7295
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MS. Elizabeth Bernadette Shelley, MSN, FNP, RN is a family nurse practitioner in Bronx, NY with 9 years of experience. MS. Elizabeth Bernadette Shelley, MSN, FNP, RN NPI is 1073862207. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2015 GRAND CONCOURSE
BRONX, NY
ZIP 10453-303
Phone: (718) 299-7295
Fax: (718) 299-6797

The NPI 1073862207 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/4/2012 and was last updated on 3/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		652493	NEW YORK	No
2	363LF0000X	Nurse Practitioner	Family	F339329	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	04103251	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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