MEDICARE: JULIANA M SHAH APNP

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	207RR0500X	Rheumatology Physician	6715-33	WI
2	363LA2200X	Adult Health Nurse Practitioner	6715-33	WI
3	363LP2300X	Primary Care Nurse Practitioner	6715 - 33	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407211287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA M SHAH APNP

Provider Business Mailing Address
First Line	:	20800 SWENSON DR STE 175
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53186-4000
Country	:	US
Telephone Number	:	262-785-0777
Fax Number	:	262-785-8029

Provider Business Practice Location Address
First Line	:	20800 SWENSON DR STE 175
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53186-4000
Country	:	US
Telephone Number	:	262-785-1964
Fax Number	:	262-785-8029

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

Provider Enumeration Date	:	12/22/2015
Last Update Date	:	06/08/2026

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Directions to “ JULIANA M SHAH APNP” Practice Location

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