Alexa-Dizard, Shelby Danielle

Alexa-Dizard, Shelby Danielle is an individual health care provider with primary practice located at 136 Lake St Ste 11 , Newburgh NY 12550-5245. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Other Service Providers / Midwife, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Alexa-Dizard, Shelby Danielle can be contacted via phone (845) 562-7800.

Contact Information

Primary practice address
136 Lake St Ste 11 Newburgh NY 12550-5245
Phone: (845) 562-7800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 685729 New York
Other Service Providers / Midwife 176B00000X F001920 New York
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 421498 New York

Profile Details

NPI number 1770141616
LBN Legal business name Alexa-Dizard, Shelby Danielle
Credentials CNM/WHNP, RN
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2019
Last updated Feb 1st, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770141616 NPPES
New York Other 001920 CNM
New York Other 421498 CNM

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