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Individual

MS. MEG SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6980
(414) 955-6204
Mailing address
9200 W WISCONSIN AVE, CARDIOTHORACIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 955-6980
(414) 955-6204

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
77437
WI
363LA2200X
Adult Health Nurse Practitioner
77437
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002000226K
HUMANA
05
1427000280
WI
Enumeration date
05/17/2006
Last updated
10/01/2014
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