Provider Demographics
NPI:1215199443
Name:SHAUB, DELORIS ANN (RN)
Entity Type:Individual
Prefix:
First Name:DELORIS
Middle Name:ANN
Last Name:SHAUB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 ALDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4200
Mailing Address - Country:US
Mailing Address - Phone:406-245-7318
Mailing Address - Fax:
Practice Address - Street 1:1127 ALDERSON AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4200
Practice Address - Country:US
Practice Address - Phone:406-245-7318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12566163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse