Individual
SHOUA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 802-2100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14533-033
WI
363LF0000X
Family Nurse Practitioner
95009840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255977
—
WI
Enumeration date
09/02/2018
Last updated
12/01/2023
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