Individual
SHARON K DE VRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
725 AMERICAN AVE FL 3, WAUKESHA, WI 53188-5031
(259) 426-2928
Mailing address
725 AMERICAN AVE FL 3, WAUKESHA, WI 53188-5031
(259) 426-2928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
516
WI
363AM0700X
Medical Physician Assistant
516
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42934200
—
WI
Enumeration date
07/13/2006
Last updated
02/22/2023
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