Individual
MR. SHANE DAVID ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
214 S 1ST ST, OSKALOOSA, IA 52577-3105
(641) 200-1165
(336) 900-1572
Mailing address
214 S 1ST ST, OSKALOOSA, IA 52577-3105
(641) 200-1165
(336) 900-1572
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5009250
NC
363L00000X
Nurse Practitioner
71001
ID
363L00000X
Nurse Practitioner
Primary
A165967
IA
363LF0000X
Family Nurse Practitioner
5009250
NC
Other
Enumeration date
01/04/2017
Last updated
12/27/2022
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