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General NPI Number Information
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NPI Number | 1962356980
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Entity Type | Individual
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Provider Name | SHELLEY FORBUS
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Gender | Female
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 4500 W LOOMIS RD
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City | GREENFIELD
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State | WI
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Zip | 53220-4819
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Country | US
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Telephone | 414-325-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 125 S 84TH ST STE 400
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City | MILWAUKEE
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State | WI
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Zip | 53214-1469
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Country | US
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Telephone | 262-290-1813
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Fax | 877-606-4443
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1800833
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License Number State | WI
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