Provider Demographics
NPI:1215178439
Name:CASSEL, SHELBI LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHELBI
Middle Name:LYNN
Last Name:CASSEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHELBI
Other - Middle Name:LYNN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0501
Mailing Address - Country:US
Mailing Address - Phone:907-442-3804
Mailing Address - Fax:
Practice Address - Street 1:733 2ND AVE
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-0501
Practice Address - Country:US
Practice Address - Phone:907-442-7443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP 60013980164W00000X
AK6466164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse