Provider Demographics
NPI:1962786806
Name:ANDRUS, SHELLEY LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:LOUISE
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3217
Mailing Address - Country:US
Mailing Address - Phone:406-455-5000
Mailing Address - Fax:406-455-2373
Practice Address - Street 1:500 15TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4304
Practice Address - Country:US
Practice Address - Phone:406-455-2357
Practice Address - Fax:406-455-2373
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21641363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health