Individual
SHELLY ANN VAN DE WEERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
916 S 10TH ST, WAUSAU, WI 54403-6502
(715) 570-8912
Mailing address
1300 N 9TH AVE, WAUSAU, WI 54401-2683
(715) 551-0346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
19877130
WI
163W00000X
Registered Nurse
Primary
198871
WI
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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