JORDAN FRAZIER SHELBURNE FNP NPI 1083202725

NPI Information

NPI: 1083202725
Provider Name: JORDAN FRAZIER SHELBURNE, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2410 SUSANNAH ST
JOHNSON CITY, TN
ZIP 37601
Phone: (423) 282-9011
Get Directions

Jordan Frazier Shelburne, FNP is a family nurse practitioner in Johnson City, TN with 4 years of experience. Jordan Frazier Shelburne, FNP NPI is 1083202725. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2410 SUSANNAH ST
JOHNSON CITY, TN
ZIP 37601-748
Phone: (423) 282-9011

The NPI 1083202725 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/7/2021 and was last updated on 11/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	28750	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	28750	OTHER	TENNESSEE	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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