Individual
JOAN ELIZABETH SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1185 CORPORATE CENTER DR, SUITE 300, OCONOMOWOC, WI 53066-4887
(262) 567-5190
(262) 567-5259
Mailing address
1185 CORPORATE CENTER DR, SUITE 300, OCONOMOWOC, WI 53066-4887
(262) 567-5190
(262) 567-5259
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5394-33
WI
363LG0600X
Gerontology Nurse Practitioner
5394-33
WI
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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