Individual
SHELLEY KAY FOUTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6901 N 72 STREET, OMAHA, NE 68122
(402) 572-2160
(402) 334-2849
Mailing address
PO BOX 34310, OMAHA, NE 68134
(402) 778-9737
(402) 334-2849
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100637
NE
367500000X
Certified Registered Nurse Anesthetist
D101829
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0520395
—
IA
05
—
470550438-15
—
NE
Enumeration date
08/25/2006
Last updated
07/08/2007
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