Healthcare Provider Details

I. General information

NPI: 1912728692
Provider Name (Legal Business Name): SHELBY STIERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 EMBASSY WEST
DUBUQUE IA
52002
US

IV. Provider business mailing address

1011 DAVIS STREET
DUBUQUE IA
52001-1306
US

V. Phone/Fax

Practice location:
  • Phone: 563-556-7878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: