Provider Demographics
NPI:1144740911
Name:SHAUGER, AMY MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:SHAUGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N8621 COUNTY ROAD F
Mailing Address - Street 2:
Mailing Address - City:SHIOCTON
Mailing Address - State:WI
Mailing Address - Zip Code:54170-8715
Mailing Address - Country:US
Mailing Address - Phone:715-250-0696
Mailing Address - Fax:
Practice Address - Street 1:N8621 COUNTY RD F
Practice Address - Street 2:
Practice Address - City:SHIOCTON
Practice Address - State:WI
Practice Address - Zip Code:54170-8715
Practice Address - Country:US
Practice Address - Phone:715-250-0696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI276367164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse