MEDICARE: MRS. SHRON MARIE CHRISTMAN-POWELL HCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1083782148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHRON MARIE CHRISTMAN-POWELL HCP

Provider Business Mailing Address
First Line	:	1535 W MARKET ST
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-5053
Country	:	US
Telephone Number	:	262-241-9224
Fax Number	:	262-241-9228

Provider Business Practice Location Address
First Line	:	1535 W MARKET ST
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-5053
Country	:	US
Telephone Number	:	262-241-9224
Fax Number	:	262-241-9228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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