Provider Demographics
NPI:1376349266
Name:SHELBY, DUSTI
Entity type:Individual
Prefix:
First Name:DUSTI
Middle Name:
Last Name:SHELBY
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:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-0347
Mailing Address - Country:US
Mailing Address - Phone:402-890-7458
Mailing Address - Fax:
Practice Address - Street 1:311 E 1ST ST
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-7081
Practice Address - Country:US
Practice Address - Phone:402-890-7458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities