Provider Demographics
NPI:1952105405
Name:DENNHARDT, SHIRLEY M
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:M
Last Name:DENNHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 GOLDEN GATE DR APT 141
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2875
Mailing Address - Country:US
Mailing Address - Phone:308-930-0867
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3636
Practice Address - Country:US
Practice Address - Phone:402-682-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant