Provider Demographics
NPI:1700118387
Name:SHELBY, JULIA ANN (NP)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANN
Last Name:SHELBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8734 E MURRAY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:95246-9673
Mailing Address - Country:US
Mailing Address - Phone:209-754-4783
Mailing Address - Fax:
Practice Address - Street 1:1500 S HIGHWAY 49
Practice Address - Street 2:STE 105
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2652
Practice Address - Country:US
Practice Address - Phone:209-223-5500
Practice Address - Fax:209-223-4964
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner