National Provider Identifier

Shelley Mae Bacon, NP

Shelley Mae Bacon, NP is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Amherst, NY and a listed phone number of (716) 923-4380.

NPI 1669966065Amherst, NYFamily Nurse Practitioner

Profile Overview

NPI
1669966065
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
June 19, 2018
Last Updated
June 19, 2018

Practice Location

  • 4979 Harlem RD
  • Amherst, NY 14226-2547

Phone: (716) 923-4380

Specialties

  • Family Nurse Practitioner (363LF0000X)
Full Record
NPI
1669966065
Entity Type
Individual
Last Name
Bacon
First Name
Shelley
Middle Name
Mae
Credential
NP
Mailing Street Address
4979 Harlem RD
Mailing City
Amherst
Mailing State
NY
Mailing ZIP Code
14226-2547
Mailing Country
US
Mailing Phone
(716) 923-4380
Practice Street Address
4979 Harlem RD
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14226-2547
Practice Country
US
Practice Phone
(716) 923-4380
Practice Fax
(716) 923-4384
Enumeration Date
June 19, 2018
Last Updated
June 19, 2018
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X)