Individual
SHIVANI A PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(800) 326-2250
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9945-33
WI
363LF0000X
Family Nurse Practitioner
289311
AZ
363LF0000X
Family Nurse Practitioner
RN2283371
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102478
—
WI
Enumeration date
08/04/2014
Last updated
09/10/2025
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