Individual
MS. NANCY SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-8393
Mailing address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-6558
(920) 568-4004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1697
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011361
PHYSICIANS PLUS
WI
05
—
39634600
—
WI
Enumeration date
10/11/2005
Last updated
05/04/2021
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