Provider Demographics
NPI:1134912553
Name:SHETLER, ABIGAIL C
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:C
Last Name:SHETLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-0939
Mailing Address - Country:US
Mailing Address - Phone:531-248-1840
Mailing Address - Fax:
Practice Address - Street 1:1719 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-8248
Practice Address - Country:US
Practice Address - Phone:531-248-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician