Individual
DR. KELLY LYNN SHANLEY NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 233-7500
(715) 233-7501
Mailing address
3706 TIFFANY LN, EAU CLAIRE, WI 54701-5635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14450-040
WI
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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