Individual provider · NPI-1

Shelby Athanaelos

Nurse Practitioner · Evans, GA

NPI number1821941121
StatusActive
Last updated in NPPESNov 3, 2026

Details

NPI
1821941121
Entity type
Individual (NPI-1)
Name
Shelby Athanaelos
Sex
Female
Sole proprietor
No
Enumeration date
Feb 17, 2026
Certification date
Nov 3, 2026
Last updated
Nov 3, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerGAA-NP005514GAYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3346

Phone 706-722-0705 · Fax 706-722-7315

Mailing address

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3346

Phone 706-722-0705 · Fax 706-722-7315

Other practice locations

1601 Greene St
Columbia, SC 29208-4001

Phone 803-777-7412

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