Provider Demographics
NPI:1255022174
Name:DOBRICH, SHELBY ELISE (APRN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ELISE
Last Name:DOBRICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CLUB RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2460
Mailing Address - Country:US
Mailing Address - Phone:314-546-5769
Mailing Address - Fax:
Practice Address - Street 1:44 CLUB RD STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2460
Practice Address - Country:US
Practice Address - Phone:314-546-5769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10008134163W00000X, 363LP0808X
MO2018024074163W00000X
MO2023007985363LP0808X
IDTEMP76102363LP0808X
AZ293210363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse