Provider Demographics
NPI:1467181503
Name:OAKLEY, SHELBY (HIS)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N 14TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0697
Mailing Address - Country:US
Mailing Address - Phone:701-805-8057
Mailing Address - Fax:
Practice Address - Street 1:3000 N 14TH ST STE C
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0697
Practice Address - Country:US
Practice Address - Phone:701-805-8057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND0360237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist