Provider Demographics
NPI:1548558190
Name:TENCLEVE, SHELBY D (CRNA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:D
Last Name:TENCLEVE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:D
Other - Last Name:BRUEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-0356
Mailing Address - Country:US
Mailing Address - Phone:800-374-5326
Mailing Address - Fax:800-374-5326
Practice Address - Street 1:8080 E CENTRAL AVE STE 250
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2367
Practice Address - Country:US
Practice Address - Phone:316-686-7327
Practice Address - Fax:316-686-1557
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1396203061163W00000X
KS557044367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse