Provider Demographics
NPI:1730801853
Name:DENNIS, SHELLEY DAWN
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:DAWN
Last Name:DENNIS
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 1:910 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3201
Mailing Address - Country:US
Mailing Address - Phone:308-698-8230
Mailing Address - Fax:308-698-8235
Practice Address - Street 1:910 E 34TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3201
Practice Address - Country:US
Practice Address - Phone:308-698-8230
Practice Address - Fax:308-698-8235
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide