Individual
SHANNON R. WIXOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5801 RESEARCH PARK BLVD STE 400, MADISON, WI 53719-6003
(608) 729-6344
Mailing address
5801 RESEARCH PARK BLVD STE 400, MADISON, WI 53719-6003
(608) 729-6344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
151252-30
WI
363LF0000X
Family Nurse Practitioner
Primary
9059-33
WI
Other
Enumeration date
02/11/2019
Last updated
05/31/2022
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