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NPI Code Detail

MEDICARE: SHELBY LYNN BREVER MS, LAT, ATC

MEDICARE:   SHELBY LYNN BREVER  MS, LAT, ATC
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
12255A2300XAthletic Trainer3353-39WI

General Provider Information

NPI Number : 1952197733
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY LYNN BREVER MS, LAT, ATC
Provider Business Mailing Address
First Line : 3908 DOOLITTLE DR APT 7
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-7323
Country : US
Telephone Number : 715-896-7272
Fax Number :
Provider Business Practice Location Address
First Line : 1041 HILL ST
Second Line :
City : WISCONSIN RAPIDS
State : WI
Zip : 54494-5221
Country : US
Telephone Number : 715-424-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2025
Last Update Date : 06/08/2026

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Directions to “ SHELBY LYNN BREVER MS, LAT, ATC” Practice Location

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