Individual
SHAMIAH M DEKKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5581
(414) 290-6755
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7440-33
WI
Other
Enumeration date
01/05/2017
Last updated
11/05/2020
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