| Doctor Name: | SHELBY NESTER |
| NPI Number: | 1073909131 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2306603765 |
| Business Practice Address: | 9642 Burke Lake Rd Burke, VA - 220153052 |
| Business Phone Number: | 7035437920 |
| Business Fax Number: | |
| Mailing Address: | 12906 New Parkland Dr, HERNDON |
| State: | VA |
| Postal Code: | 201712645 |
| Phone Number: | 7243447526 |
| Fax Number: | |
| NPI Enumeration Date: | 04/15/2015 |
| NPI Last Update Date: | 04/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 2306603765 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |