Provider Demographics
NPI:1033653662
Name:KNUDSEN, SHELLEY M (DVM)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:M
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S 48TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5809
Mailing Address - Country:US
Mailing Address - Phone:402-467-2711
Mailing Address - Fax:
Practice Address - Street 1:2300 S 48TH ST STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5809
Practice Address - Country:US
Practice Address - Phone:402-467-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist