Provider Demographics
NPI:1174722151
Name:SHELTON, LINDA SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BALTIC AVE.
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-231-0487
Mailing Address - Fax:
Practice Address - Street 1:38 BOLAND CT.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-640-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR105714163WC1500X, 163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health