Individual
ELIZABETH SHALLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
803 N 1ST ST, VIENNA, IL 62995-1544
(618) 658-2811
(618) 833-6267
Mailing address
1520 CEDAR GROVE RD, BUNCOMBE, IL 62912-2052
(618) 201-5926
(618) 833-6267
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018052
IL
363LF0000X
Family Nurse Practitioner
209018052
IL
Other
Enumeration date
09/18/2018
Last updated
09/04/2024
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