Individual
MS. SHANDA MARIE HUBERTUS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3016 N 13TH ST, WAUSAU, WI 54403-3027
(715) 845-7422
(715) 848-1514
Mailing address
3016 N 13TH ST, WAUSAU, WI 54403-3027
(715) 845-7422
(715) 848-1514
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38278100
—
WI
Enumeration date
03/22/2006
Last updated
07/09/2007
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