Individual
SHANNON M THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051-2810
(262) 251-7500
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(920) 303-8700
(920) 456-5901
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6749
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100050612
—
WI
Enumeration date
12/11/2015
Last updated
02/22/2023
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