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MS. SHANNON M BIBIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
725 AMERICAN AVE, WAUKESHA, WI 53188-5031
(262) 928-2594
(414) 805-5809
Mailing address
1336 PARK AVE, SOUTH MILWAUKEE, WI 53172-1133
(414) 940-0278
(414) 301-9508

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
156515
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
156515
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588891097
WI
Enumeration date
06/11/2009
Last updated
12/01/2022
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