Provider Demographics
NPI:1033924873
Name:TINNEY, SHELBY LOUISE (FNP-C)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LOUISE
Last Name:TINNEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 ELDERBERRY DR
Mailing Address - Street 2:
Mailing Address - City:VASS
Mailing Address - State:NC
Mailing Address - Zip Code:28394-8444
Mailing Address - Country:US
Mailing Address - Phone:806-676-1094
Mailing Address - Fax:
Practice Address - Street 1:100 S 10TH ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-6690
Practice Address - Country:US
Practice Address - Phone:910-893-4111
Practice Address - Fax:910-893-9850
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021639363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner