Individual
SHANNON SCALISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-0079
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-0079
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
222539
WI
363L00000X
Nurse Practitioner
Primary
8680
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376035782
—
WI
Enumeration date
05/31/2018
Last updated
12/06/2021
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