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General NPI Number Information
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NPI Number | 1578071320
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Entity Type | Individual
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Provider Name | CINDY MARIE SHUPE MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 201 RIDGE ST STE 206
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4643
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Country | US
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Telephone | 712-397-7460
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Fax | 712-396-7465
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Provider Business Mailing Address
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Address Line | 201 RIDGE ST STE 206
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4643
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Country | US
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Telephone | 712-242-7082
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A111729
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | A111729
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11250
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License Number State | NE
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