Provider Demographics
NPI:1679884936
Name:TASH, SHELLY B
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:B
Last Name:TASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 N FRANKLIN ST STE 203
Mailing Address - Street 2:PO BOX 650
Mailing Address - City:CUBA
Mailing Address - State:MO
Mailing Address - Zip Code:65453-1719
Mailing Address - Country:US
Mailing Address - Phone:573-205-5803
Mailing Address - Fax:888-737-5608
Practice Address - Street 1:412 N FRANKLIN ST STE 203
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:MO
Practice Address - Zip Code:65453-1719
Practice Address - Country:US
Practice Address - Phone:573-205-5803
Practice Address - Fax:888-737-5608
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based