Individual
SOPHIE ANN SHACKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5543 E CHERYL PKWY, FITCHBURG, WI 53711-5376
(608) 274-5300
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8537-23
WI
363AM0700X
Medical Physician Assistant
Primary
PA.0006903
CO
Other
Enumeration date
05/11/2020
Last updated
03/13/2026
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