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NPI Code Detail

MEDICARE: SHAYLYN FUERSTENAU

MEDICARE: SHAYLYN FUERSTENAU
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1932726510
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYLYN FUERSTENAU
Provider Business Mailing Address
First Line : 3344 E ALLERTON AVE
Second Line :
City : CUDAHY
State : WI
Zip : 53110-1016
Country : US
Telephone Number : 414-881-5515
Fax Number :
Provider Business Practice Location Address
First Line : 3409 N DOWNER AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-2934
Country : US
Telephone Number : 414-229-3914
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2020
Last Update Date : 06/30/2020

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Directions to “ SHAYLYN FUERSTENAU ” Practice Location

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