Provider Demographics
NPI:1912569443
Name:ROOKSTOOL, SHELBY DELRAE (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:DELRAE
Last Name:ROOKSTOOL
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 NORRIS AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-2054
Mailing Address - Country:US
Mailing Address - Phone:308-520-4837
Mailing Address - Fax:
Practice Address - Street 1:212 W 9TH ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3515
Practice Address - Country:US
Practice Address - Phone:308-345-2954
Practice Address - Fax:308-345-7719
Is Sole Proprietor?:No
Enumeration Date:2019-07-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1505152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist