Provider Demographics
NPI:1902295926
Name:SHELTON, LORA (FNP-BC, DNP)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH AVE SOUTH, STE 103
Mailing Address - Street 2:ST. VINCENT'S OCCUPATIONAL HEALTH CLINIC 1
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-930-2600
Mailing Address - Fax:205-930-2605
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 103
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-930-2600
Practice Address - Fax:205-930-2605
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-074508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily