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General NPI Number Information
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NPI Number | 1457406654
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Entity Type | Individual
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Provider Name | SHELLY JEAN VAN NOTE PHARM D
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 HIGHLAND AVE UNIVERSITY OF WISCONSIN HOSPITAL & CLINICS F61 331 530
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City | MADISON
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State | WI
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Zip | 53792
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Country | US
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Telephone | 608-263-1290
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Fax | 608-263-9424
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Provider Business Mailing Address
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Address Line | 18 ARIAL CIRCLE
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City | MADISON
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State | WI
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Zip | 53719
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Country | US
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Telephone | 608-263-8475
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Fax | 608-263-8027
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12193040
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License Number State | WI
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