Healthcare Provider Details

I. General information

NPI: 1376467233
Provider Name (Legal Business Name): SHANNON E. JONES BSN-RN, NCSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 OWENA ST
MARINETTE WI
54143-1948
US

IV. Provider business mailing address

826 OWENA ST
MARINETTE WI
54143-1948
US

V. Phone/Fax

Practice location:
  • Phone: 715-735-1320
  • Fax: 715-732-3434
Mailing address:
  • Phone: 715-735-1320
  • Fax: 715-732-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number189342-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: