Provider Demographics
NPI:1144002817
Name:LIGMAN, SHELBY LORI (APNP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LORI
Last Name:LIGMAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LORI
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APNP
Mailing Address - Street 1:2340 EASLAN DR
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-3241
Mailing Address - Country:US
Mailing Address - Phone:171-557-2862
Mailing Address - Fax:
Practice Address - Street 1:410 DEWEY ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-4715
Practice Address - Country:US
Practice Address - Phone:715-423-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14650-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily