Individual
ELIZABETH J. SHIMEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9697 SAINT CATHERINES DR STE 200, PLEASANT PRAIRIE, WI 53158-2118
(262) 656-3590
(262) 656-3591
Mailing address
9697 SAINT CATHERINES DR STE 200, PLEASANT PRAIRIE, WI 53158-2118
(262) 656-3590
(262) 656-3591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4012-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4012-23
WI LICENSE
WI
01
—
K400441598
MEDICARE
WI
Enumeration date
10/26/2017
Last updated
04/08/2020
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