Provider Demographics
NPI:1689348633
Name:ERNST, SHONA RAE (ARNP)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:RAE
Last Name:ERNST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-9542
Mailing Address - Country:US
Mailing Address - Phone:563-508-3236
Mailing Address - Fax:
Practice Address - Street 1:1737 HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-9542
Practice Address - Country:US
Practice Address - Phone:563-508-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA164963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine