| NPI | 1386148211 |
|---|---|
| Former Name | SHELBY JO PRIDDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA3652) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA3652) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-07-01 |