Provider Demographics
NPI:1801238357
Name:SHELTON, AMY K (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:SHELTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:100 E OUTER RD
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:MO
Practice Address - Zip Code:63780-1229
Practice Address - Country:US
Practice Address - Phone:573-264-2211
Practice Address - Fax:573-264-2177
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2021-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2013019617363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant