Healthcare Provider Details

I. General information

NPI: 1962359737
Provider Name (Legal Business Name): KARA SHEPRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 E 2ND ST
MERRILL WI
54452-2419
US

IV. Provider business mailing address

800 E ATWATER AVE
BLOOMINGTON IN
47405-3635
US

V. Phone/Fax

Practice location:
  • Phone: 715-536-4292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4141-35
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: