Healthcare Provider Details

I. General information

NPI: 1326992140
Provider Name (Legal Business Name): CAITLYNNE JOIS SHADLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE
AMES IA
50010-5745
US

IV. Provider business mailing address

3400 AURORA AVE APT 104
AMES IA
50014-8524
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-2011
  • Fax:
Mailing address:
  • Phone: 515-298-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number170979
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: