Provider Demographics
NPI:1548025943
Name:VALDEZ-SHOGREN, SUSANA E (RN)
Entity type:Individual
Prefix:MISS
First Name:SUSANA
Middle Name:E
Last Name:VALDEZ-SHOGREN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-3930
Mailing Address - Country:US
Mailing Address - Phone:608-213-1680
Mailing Address - Fax:
Practice Address - Street 1:981 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-3930
Practice Address - Country:US
Practice Address - Phone:608-213-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI110400-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse