Basic Information
| Provider Information | |||||||||
| NPI: | 1407381148 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REGISTER | ||||||||
| FirstName: | SHELBY | ||||||||
| MiddleName: | LAUREN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 439 US HIGHWAY 158 W | ||||||||
| Address2: | |||||||||
| City: | YANCEYVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273798304 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 439 US HIGHWAY 158 W | ||||||||
| Address2: | |||||||||
| City: | YANCEYVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273798304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366949331 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 0101272205 | VA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 2019-00348 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.