Provider Demographics
NPI:1871276667
Name:FLORA, SHELLEE (FNP)
Entity type:Individual
Prefix:
First Name:SHELLEE
Middle Name:
Last Name:FLORA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 TEACO RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-3266
Mailing Address - Country:US
Mailing Address - Phone:573-559-3591
Mailing Address - Fax:573-559-3575
Practice Address - Street 1:304 TEACO RD
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3266
Practice Address - Country:US
Practice Address - Phone:573-559-3591
Practice Address - Fax:573-559-3575
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily