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NPI Code Detail

MEDICARE: SHELLI J MABE CRNA

MEDICARE: SHELLI J MABE CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist112997MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992715692
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLI J MABE CRNA
Provider Business Mailing Address
First Line : PO BOX 9007
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65808-9007
Country : US
Telephone Number : 417-875-3000
Fax Number :
Provider Business Practice Location Address
First Line : 525 BRANSON LANDING BLVD
Second Line :
City : BRANSON
State : MO
Zip : 65616-2052
Country : US
Telephone Number : 417-335-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 12/14/2020

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Directions to “ SHELLI J MABE CRNA” Practice Location

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