Smith, Shannon M
Smith, Shannon M is an individual health care provider with primary practice located at 855 N Westhaven Dr , Oshkosh WI 54904-7668. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Smith, Shannon M can be contacted via phone (920) 456-6000.Contact Information
Primary practice address
855 N Westhaven Dr
Oshkosh WI 54904-7668
Phone: (920) 456-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 9893 | Wisconsin |
Profile Details
| NPI number | 1649567751 |
|---|---|
| LBN Legal business name | Smith, Shannon M |
| Credentials | CNM, RN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2011 |
| Last updated | Nov 23rd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649567751 | NPPES |
| Wisconsin | MEDICAID | 100098809 |
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