Provider Demographics
NPI:1578071320
Name:SHUPE, CINDY MARIE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIE
Last Name:SHUPE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:GREGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 RIDGE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-4643
Mailing Address - Country:US
Mailing Address - Phone:712-242-7082
Mailing Address - Fax:
Practice Address - Street 1:201 RIDGE ST STE 206
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4643
Practice Address - Country:US
Practice Address - Phone:712-397-7460
Practice Address - Fax:712-396-7465
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA111729363LF0000X, 363LP2300X
NE11250363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily