Healthcare Provider Details

I. General information

NPI: 1629956693
Provider Name (Legal Business Name): SHELBY ELIZABETH MAE BOWNES CNA, DSP, HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 PIERCE ST
SIOUX CITY IA
51101-1414
US

IV. Provider business mailing address

818 5TH ST
SIOUX CITY IA
51101-1303
US

V. Phone/Fax

Practice location:
  • Phone: 712-355-9550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number278217
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number142923
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: