Provider Demographics
NPI:1861086654
Name:SHELBY, MELISSA (PMHNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SHELBY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 PARKER CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2813
Mailing Address - Country:US
Mailing Address - Phone:901-205-4600
Mailing Address - Fax:
Practice Address - Street 1:6005 PARK AVE STE 630B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5226
Practice Address - Country:US
Practice Address - Phone:901-767-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN288922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry