Huettl, Shannon L.

Huettl, Shannon L. is an individual health care provider with primary practice located at 333 N Green Bay Rd , Neenah WI 54956-1954. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Huettl, Shannon L. can be contacted via phone (920) 729-6088.

Contact Information

Primary practice address
333 N Green Bay Rd Neenah WI 54956-1954
Phone: (920) 729-6088
Fax: (920) 729-6484
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1435 Wisconsin

Profile Details

NPI number 1194752824
LBN Legal business name Huettl, Shannon L.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Feb 20th, 2024 - about 10 months 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 1194752824 NPPES
Wisconsin MEDICAID 41967100

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