Provider Demographics
NPI:1770969339
Name:DUNN, SHELLEY (NP-C)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:DUNN
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2503
Mailing Address - Country:US
Mailing Address - Phone:260-824-3500
Mailing Address - Fax:
Practice Address - Street 1:303 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2503
Practice Address - Country:US
Practice Address - Phone:260-824-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28138587A363LF0000X
IN71005690A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201318570Medicaid
IN234760037Medicare PIN