Shideman, Jeffrey Anton

Shideman, Jeffrey Anton is an individual health care provider with primary practice located at 61 S Gould St , Sheridan WY 82801-6304. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Shideman, Jeffrey Anton can be contacted via phone (307) 675-2690.

Contact Information

Primary practice address
61 S Gould St Sheridan WY 82801-6304
Phone: (307) 675-2690
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 44709 Wyoming

Profile Details

NPI number 1699316430
LBN Legal business name Shideman, Jeffrey Anton
Credentials DNP, NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2019
Last updated Oct 13th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699316430 NPPES
Wyoming MEDICAID 154294000

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