Provider Demographics
NPI:1699322420
Name:SOMMER, SHELBY LYN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:LYN
Last Name:SOMMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:80752 ROAD 424
Mailing Address - Street 2:
Mailing Address - City:ANSELMO
Mailing Address - State:NE
Mailing Address - Zip Code:68813-7818
Mailing Address - Country:US
Mailing Address - Phone:308-660-5035
Mailing Address - Fax:
Practice Address - Street 1:80752 ROAD 424
Practice Address - Street 2:
Practice Address - City:ANSELMO
Practice Address - State:NE
Practice Address - Zip Code:68813-7818
Practice Address - Country:US
Practice Address - Phone:308-660-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2370225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist