Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1882 | WI |
NPI | 1073778502 |
---|---|
Provider Name | Sharon A Nelson |
First Address | Mequon, WI 53097-2416 |
Second Address | Waukesha, WI 53188-5031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 15/12/2021 |