Provider Demographics
NPI:1770168197
Name:BROWN, SHELDON
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHELDON
Other - Middle Name:
Other - Last Name:BUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8717 W 122ND ST N
Mailing Address - Street 2:
Mailing Address - City:MINGO
Mailing Address - State:IA
Mailing Address - Zip Code:50168-8570
Mailing Address - Country:US
Mailing Address - Phone:515-943-2787
Mailing Address - Fax:
Practice Address - Street 1:55 UNITYPOINT WAY
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4749
Practice Address - Country:US
Practice Address - Phone:319-356-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAD174507367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program