Individual
TYLER WILLIAM SHIMEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 901-9496
Mailing address
3014 QUARRY PARK DR APT 4, DE PERE, WI 54115-8192
(920) 901-9496
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
131883
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
08/09/2020
Last updated
12/21/2021
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