Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063491405 Individual Practitioner Female Practitioner

Shelly Y Gresham , RNC-FNP

Nurse Practitioner • Poplar Bluff, MO

Professional Overview & Biography Verified Profile Summary

Shelly Gresham, RNC-FNP is a registered healthcare professional specializing in Nurse Practitioner in Poplar Bluff, MO. Practice services are available at 2480 THREE RIVERS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2480 Three Rivers Blvd

Poplar Bluff, MO 639012318

Telephone 5736865564
Fax 5736862838
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Poplar Bluff, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.9 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
21 Specialists

Practicing in Poplar Bluff, MO (1750 Statewide)

Telehealth Adoption Rate
4.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License MO 126637

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
428569842 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Ellen Howell , FNP

Nurse Practitioner

NPI 1679552012

Family Nurse Practitioner

NPI 1811088594

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 22, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location September 22, 2009

Registered at 2480 THREE RIVERS BLVD, POPLAR BLUFF, MO 639012318 (Tel: 5736865564)

📍
Updated Business Mailing Address September 22, 2009

Registered at 2480 THREE RIVERS BLVD, POPLAR BLUFF, MO 639012318 (Tel: 5736865564)

👤
Provider Name / Credentials Updated September 22, 2009

Recorded as SHELLY GRESHAM, RNC-FNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2009

Nurse Practitioner (License #126637 in MO)

🟢
Initial NPI Registration & Enumeration January 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063491405
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 13, 2006
Last Update: September 22, 2009
Sole Proprietor: No

Mailing Address

2480 Three Rivers Blvd

Poplar Bluff, MO 639012318

Phone: 5736865564

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.