Individual
SHARI K VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
717 W MORELAND BLVD, PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC, WAUKESHA, WI 53188-2432
(262) 542-9100
Mailing address
717 W MORELAND BLVD, PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC, WAUKESHA, WI 53188-2432
(262) 542-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
468-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42979700
—
WI
Enumeration date
12/21/2005
Last updated
06/18/2014
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