Healthcare Provider Details

I. General information

NPI: 1003757808
Provider Name (Legal Business Name): ANGELCARE MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E LAKE DR
SHELL LAKE WI
54871-8749
US

IV. Provider business mailing address

1314 E LAKE DR
SHELL LAKE WI
54871-8749
US

V. Phone/Fax

Practice location:
  • Phone: 715-645-9583
  • Fax:
Mailing address:
  • Phone: 715-645-9583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA SUE ST. ONGE
Title or Position: OWNER/NURSE PRACTITIONER
Credential: APRN
Phone: 715-645-9583