Gudehus, Shelly L

Gudehus, Shelly L is an individual health care provider with primary practice located at 1125 Madison St , Jefferson City MO 65101-5227. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gudehus, Shelly L can be contacted via phone (573) 632-5580.

Contact Information

Primary practice address
1125 Madison St Jefferson City MO 65101-5227
Phone: (573) 632-5580
Fax: (573) 632-5876
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209000687 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 133429 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 133429 Missouri

Profile Details

NPI number 1629043849
LBN Legal business name Gudehus, Shelly L
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Nov 8th, 2016 - about 8 years 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 1629043849 NPPES
Missouri Other 133429 MO LICENSE
Missouri Other RN LICENSE MO LICENSE

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