Healthcare Provider Details

I. General information

NPI: 1952266322
Provider Name (Legal Business Name): SHANETTE RATTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 N 36TH ST UPPR
MILWAUKEE WI
53208-1406
US

IV. Provider business mailing address

2107 N 36TH ST UPPR
MILWAUKEE WI
53208-1406
US

V. Phone/Fax

Practice location:
  • Phone: 414-367-7150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: