MRS. MARY C SHELLNUTT APRN AGCNS-BC NPI 1811366552

NPI Information

  • NPI: 1811366552
  • Provider Name: MRS. MARY C SHELLNUTT, APRN, AGCNS-BC
  • Classification: Clinical Nurse Specialist - 364S00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 501 SAUNDERS AVE STE 320
    TYLER, TX
    ZIP 75702
  • Phone: (903) 606-5140

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NPI Details

MRS. Mary C Shellnutt, APRN, AGCNS-BC is a clinical nurse specialist in Tyler, TX with 8 years of experience. The provider is a registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. MRS. Mary C Shellnutt, APRN, AGCNS-BC NPI is 1811366552. 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:

501 SAUNDERS AVE STE 320
TYLER, TX
ZIP 75702-524
Phone: (903) 606-5140

The NPI 1811366552 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 9/23/2015 and was last updated on 3/12/2024.

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
1364SA2200XClinical Nurse SpecialistAdult HealthAP128617TEXASNo
2364S00000XClinical Nurse SpecialistAP128617TEXASYes
3364SG0600XClinical Nurse SpecialistGerontologyAP128617TEXASNo

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: 11/21/2025

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