Individual
SHELLY S DEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6416 S HOWELL AVE, OAK CREEK, WI 53154-1104
(144) 304-5713
Mailing address
6416 S HOWELL AVE, OAK CREEK, WI 53154-1104
(144) 304-5713
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7816
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7816
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
7816-33
WI
Other
Enumeration date
09/17/2012
Last updated
09/17/2024
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