Provider Demographics
NPI:1679847875
Name:SHELTON, PATRICIA HUFF (NNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HUFF
Last Name:SHELTON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7730
Mailing Address - Country:US
Mailing Address - Phone:336-478-1016
Mailing Address - Fax:
Practice Address - Street 1:628 GREEN VALLEY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7730
Practice Address - Country:US
Practice Address - Phone:336-478-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC58904363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal