Individual
JACQUELINE K SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
9200 W WISCONSIN AVE, TRANSPLANT SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-3100
(414) 259-1145
Mailing address
9200 W WISCONSIN AVE, TRANSPLANT SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-3100
(414) 259-1145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3196
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699961763
—
WI
Enumeration date
09/21/2007
Last updated
12/11/2013
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