Provider Demographics
NPI:1164192290
Name:DEXTER, SHELBI (ARNP)
Entity Type:Individual
Prefix:
First Name:SHELBI
Middle Name:
Last Name:DEXTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 2ND ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2506
Mailing Address - Country:US
Mailing Address - Phone:641-684-8448
Mailing Address - Fax:
Practice Address - Street 1:301 W 2ND ST STE 2
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2506
Practice Address - Country:US
Practice Address - Phone:641-684-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165853363LF0000X
IA127928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse