Provider Demographics
NPI:1588481394
Name:SHIFLETT, DANA (CMA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SHIFLETT
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-3149
Mailing Address - Country:US
Mailing Address - Phone:641-782-8457
Mailing Address - Fax:641-782-7048
Practice Address - Street 1:210 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-3149
Practice Address - Country:US
Practice Address - Phone:641-782-8457
Practice Address - Fax:641-782-7048
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker