Individual
MS. SHANNON N COAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, HOSPITAL BASED @ FROEDTERT HOSP., MILWAUKEE, WI 53226-3522
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, HOSPITAL BASED @ FROEDTERT HOSP., MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
911
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42960500
—
WI
Enumeration date
05/13/2006
Last updated
07/08/2007
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