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Individual

SHELLEY R. DANIELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.A.

Contact information

Practice address
2727 PLAZA DR, WAUSAU, WI 54401-4129
(715) 387-7179
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5211

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
130226-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070352
CRNA RECERTIFICATION CARD
05
44328900
WI
01
P00134322
RAIL ROAD MEDICARE
Enumeration date
12/15/2005
Last updated
04/13/2023
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