MEDICARE: SHAWANNA J STANLEY

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	253Z00000X	In Home Supportive Care Agency		WI

General Provider Information

NPI Number	:	1952049009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWANNA J STANLEY

Provider Business Mailing Address
First Line	:	2128 N 16TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1214
Country	:	US
Telephone Number	:	414-882-0714
Fax Number	:

Provider Business Practice Location Address
First Line	:	2128 N 16TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1214
Country	:	US
Telephone Number	:	414-882-0714
Fax Number	:

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

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/31/2026

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Directions to “ SHAWANNA J STANLEY ” Practice Location

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