Individual
SHANNON K JACOBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3111 W RAWSON AVE, SUITE 200, FRANKLIN, WI 53132-9417
(414) 384-6700
(414) 761-1921
Mailing address
3077 N MAYFAIR RD STE 305, WAUWATOSA, WI 53222-4305
(414) 384-6700
(414) 727-1058
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4466-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760760391
—
WI
Enumeration date
08/01/2011
Last updated
03/03/2020
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