Eagen, Shelly Lynn

Eagen, Shelly Lynn is an individual health care provider with primary practice located at 600 Highland Ave , Madison WI 53792-0001. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Eagen, Shelly Lynn can be contacted via phone (608) 263-6420.

Contact Information

Primary practice address
600 Highland Ave Madison WI 53792-0001
Phone: (608) 263-6420
Fax: (608) 263-0440
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X 144314-030 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 4446-33 Wisconsin

Profile Details

NPI number 1144377631
LBN Legal business name Eagen, Shelly Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Nov 4th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144377631 NPPES
Wisconsin MEDICAID 38352100

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