Individual
SHANNON L. HUETTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2500 E CAPITOL DR STE 1700, APPLETON, WI 54911-8735
(920) 731-8131
(920) 832-0444
Mailing address
2000 E MILESTONE DR, APPLETON, WI 54913-6701
(920) 731-8131
(920) 832-0444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1435
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41967100
—
WI
Enumeration date
06/27/2006
Last updated
01/05/2026
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