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General NPI Number Information
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NPI Number | 1144740911
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Entity Type | Individual
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Provider Name | AMY MICHELLE SHAUGER LPN
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Gender | Female
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | N8621 COUNTY RD F
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City | SHIOCTON
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State | WI
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Zip | 54170-8715
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Country | US
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Telephone | 715-250-0696
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Fax |
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Provider Business Mailing Address
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Address Line | N8621 COUNTY ROAD F
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City | SHIOCTON
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State | WI
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Zip | 54170-8715
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Country | US
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Telephone | 715-250-0696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 276367
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License Number State | WI
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