Provider Demographics
NPI:1174759666
Name:ALLEN-BENITZ, SHELBY RENAE (RN BC ARNP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:RENAE
Last Name:ALLEN-BENITZ
Suffix:
Gender:F
Credentials:RN BC ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 S EISENHOWER AVE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-1562
Mailing Address - Country:US
Mailing Address - Phone:641-424-2075
Mailing Address - Fax:641-424-9555
Practice Address - Street 1:235 S EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1562
Practice Address - Country:US
Practice Address - Phone:641-424-2075
Practice Address - Fax:641-424-9555
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA105043163W00000X
IAG105043363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse