Individual
SHANNON ELIZABETH DAVISON-WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4460
(563) 584-4395
Mailing address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4100
(563) 584-4110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A114726
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016990067
MEDICARE PTAN
IA
Enumeration date
08/27/2012
Last updated
11/06/2015
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