Provider Demographics
NPI:1508743741
Name:HARPER, SHELBY MCKENZIE
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MCKENZIE
Last Name:HARPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 NISBET ST NW APT 1134
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-1053
Mailing Address - Country:US
Mailing Address - Phone:678-735-2952
Mailing Address - Fax:
Practice Address - Street 1:351 NISBET ST NW APT 1134
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-1053
Practice Address - Country:US
Practice Address - Phone:678-735-2952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program