| NPI | 1093683567 |
|---|---|
| Former Name | STACEY OGBURN SHELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R185128) |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-12-01 |