Basic Information
| Provider Information | |||||||||
| NPI: | 1447434857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VELA | ||||||||
| FirstName: | SHELLEY | ||||||||
| MiddleName: | COLENE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 COLBY AVE | ||||||||
| Address2: | |||||||||
| City: | BIG SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797205233 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 W 11TH PL | ||||||||
| Address2: | |||||||||
| City: | BIG SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797204114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4322631211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2007 | ||||||||
| LastUpdateDate: | 12/20/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 554344 | TX | Y | Nursing Service Providers | Registered Nurse |
No ID Information.