Provider Demographics
NPI:1316747850
Name:CHAVEZ, SHANIA RAE (RN)
Entity type:Individual
Prefix:
First Name:SHANIA
Middle Name:RAE
Last Name:CHAVEZ
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:SHANIA
Other - Middle Name:RAE
Other - Last Name:NEUBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:WOLF POINT
Mailing Address - State:MT
Mailing Address - Zip Code:59201-6000
Mailing Address - Country:US
Mailing Address - Phone:406-653-1641
Mailing Address - Fax:
Practice Address - Street 1:550 6TH AVE N
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-6000
Practice Address - Country:US
Practice Address - Phone:406-653-1641
Practice Address - Fax:406-653-1646
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT176085163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse