Provider Demographics
NPI:1801690011
Name:BONDURANT PSYCHIATRY
Entity type:Organization
Organization Name:BONDURANT PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:ANNIS
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:515-339-2009
Mailing Address - Street 1:88 PAINE CIR SE
Mailing Address - Street 2:OFC 603
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1449
Mailing Address - Country:US
Mailing Address - Phone:515-639-0554
Mailing Address - Fax:
Practice Address - Street 1:88 PAINE CIR SE
Practice Address - Street 2:OFC 603
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1449
Practice Address - Country:US
Practice Address - Phone:515-639-0554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty