Individual
SHELLY NANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 MERCY DR, SUITE 120, COUNCIL BLUFFS, IA 51503-3128
(712) 388-2770
Mailing address
800 MERCY DR, SUITE 120, COUNCIL BLUFFS, IA 51503-3128
(712) 388-2770
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36557
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0727099
—
IA
05
—
10025393600
—
NE
Enumeration date
05/24/2006
Last updated
01/15/2015
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