Individual
MRS. KIM MARIE SHEFCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
704 S WEBSTER AVE, STE. 300, GREEN BAY, WI 54301-3528
(920) 468-3444
(920) 432-6313
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1484
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1054037
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
05
—
32400300
—
WI
Enumeration date
07/26/2006
Last updated
12/29/2021
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