Individual
DR. JEFFREY ANTON SHIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, NP-C
Contact information
Practice address
61 S GOULD ST, SHERIDAN, WY 82801-6304
(307) 675-2690
Mailing address
1333 W 5TH ST STE 110, SHERIDAN, WY 82801-2752
(307) 675-2650
(307) 675-2651
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44709
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154294000
—
WY
Enumeration date
10/02/2019
Last updated
10/13/2022
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