| Doctor Name: | CAROL M SHELLEY |
| NPI Number: | 1124029731 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | 578399 |
| Business Practice Address: | 1004 Winscott Rd Benbrook, TX - 761262776 |
| Business Phone Number: | 8172490111 |
| Business Fax Number: | 8172490110 |
| Mailing Address: | 1004 Winscott Rd, BENBROOK |
| State: | TX |
| Postal Code: | 761262776 |
| Phone Number: | 8172490111 |
| Fax Number: | 8172490110 |
| NPI Enumeration Date: | 08/04/2005 |
| NPI Last Update Date: | 06/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 578399 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |