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Individual

MS. KIMBERLY SHAFFNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
N3143 KALE RD, LAKE GENEVA, WI 53147-3235
(262) 203-1104
Mailing address
N3143 KALE RD, LAKE GENEVA, WI 53147-3235
(262) 203-1104

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8726-33
WI
363LF0000X
Family Nurse Practitioner
209.020547
IL
363LF0000X
Family Nurse Practitioner
8726-33
WI

Other

Enumeration date
12/01/2018
Last updated
07/06/2023
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