Healthcare Provider Details

I. General information

NPI: 1699693846
Provider Name (Legal Business Name): WESLEY A SHEMANSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 COUNTY ROAD A
GREEN LAKE WI
54941-8630
US

IV. Provider business mailing address

1235 GREENFIELD TRL
OSHKOSH WI
54904-8035
US

V. Phone/Fax

Practice location:
  • Phone: 920-294-4070
  • Fax: 920-294-4139
Mailing address:
  • Phone: 920-294-4070
  • Fax: 920-294-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11489-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: