Individual
MR. SHANE T EBERHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
400 S BROADWAY ST, BURLINGTON, IA 52601-9407
(319) 768-5858
Mailing address
1706 W AGENCY RD, WEST BURLINGTON, IA 52655-1667
(319) 768-5858
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G173329
IA
Other
Enumeration date
02/13/2023
Last updated
03/12/2025
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