Individual
SHANNON PASTOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-7970
(920) 433-3498
Mailing address
PO BOX 708760, SANDY, UT 84070-8760
(801) 352-9500
(801) 352-7976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9093-33
WI
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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