MEDICARE: MS. SHANANN S DELONG M.S., CCC-A

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
1	237600000X	Audiologist-Hearing Aid Fitter	495	IA

General Provider Information

NPI Number	:	1588804157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHANANN S DELONG M.S., CCC-A

Provider Business Mailing Address
First Line	:	1551 VALLEY WEST DR
Second Line	:	SUITE 251
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1112
Country	:	US
Telephone Number	:	515-225-7966
Fax Number	:	515-645-6910

Provider Business Practice Location Address
First Line	:	1551 VALLEY WEST DR
Second Line	:	SUITE 251
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1112
Country	:	US
Telephone Number	:	515-225-7966
Fax Number	:	515-645-6910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	02/23/2009

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