Individual
DALIA F. SHAHWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2603 W RAWSON AVE, SUITE 713, OAK CREEK, WI 53154-8422
(414) 431-6900
Mailing address
2603 W RAWSON AVE, SUITE 713, OAK CREEK, WI 53154-8422
(414) 431-6900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5100-33
WI
363LA2200X
Adult Health Nurse Practitioner
5100-33
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
5100-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639190671
—
WI
Enumeration date
10/16/2012
Last updated
02/01/2016
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