Provider Demographics
NPI:1750067302
Name:SHELTON, KERRIGAN BETH
Entity type:Individual
Prefix:
First Name:KERRIGAN
Middle Name:BETH
Last Name:SHELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERRIGAN
Other - Middle Name:BETH
Other - Last Name:ANSPAUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:776 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68959-2241
Mailing Address - Country:US
Mailing Address - Phone:308-390-0338
Mailing Address - Fax:
Practice Address - Street 1:776 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NE
Practice Address - Zip Code:68959-2241
Practice Address - Country:US
Practice Address - Phone:308-390-0338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program