Individual
MADELINE SHANE EGGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 E GRANT ST, APPLETON, WI 54911-3483
(920) 831-5050
Mailing address
820 E GRANT ST, APPLETON, WI 54911-3483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5672
WI
363AS0400X
Surgical Physician Assistant
Primary
5672
WI
Other
Enumeration date
11/11/2021
Last updated
03/08/2023
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