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Individual

KRISTIE K SHAPPELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
32748
IA
207W00000X
Ophthalmology Physician
Primary
42009
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34021400
WI
Enumeration date
06/09/2005
Last updated
04/23/2015
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