KIMBERLY MARIA SHORTNER (NPI# 1063938595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063938595 |
| Entity Type | Individual |
| Full Name | KIMBERLY MARIA SHORTNER |
| Credential | SAC-IT |
| Practice Address |
9532 E. 16 Frontage Rd. Ste. 100 Onalaska WI 54650-6742 |
| Mailing Address |
9532 E 16 Frontage Rd Ste 100 Onalaska WI 54650-6742 |
| Practice Telephone | 6087830506 |
| Practice Fax Number | 6087830242 |
| Mailing Telephone | 6087830506 |
| Mailing Fax Number | 6087830242 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18207-130 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1003150004 | 05 |
| Street Address |
9532 E. 16 FRONTAGE RD. STE. 100 |
| City | ONALASKA |
| State | WI |
| Zip Code | 54650-6742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568824027 | Kyle Quillin | Student in an Organized Health Care Education/Training Program | 236 Kevin Ct, Onalaska, WI 54650 | 2016-03-24 |
| 1831577881 | Katelyn Nicole Patten | Counselor | 575 Lester Ave, Onalaska, WI 54650 | 2015-05-11 |
| 1619369758 | Amelia Vruble | Registered Nurse | 1047 Terrace Drive, Onalaska, WI 54650 | 2015-02-26 |
| 1699186528 | C. Nathan Vannatta | Physical Therapist | 3111 Gunersen Dr, Onalaska, WI 54650 | 2014-05-13 |
| 1770867640 | Claire Sweet | Pharmacist | 9400 Hwy 16, Target T-0620, Onalaska, WI 54650 | 2011-10-10 |
| 1306140439 | Jared I Darveaux | Internal Medicine | 311 Gundersen Dr, Onalaska, WI 54650 | 2011-01-04 |
| 1326299488 | Demetrios Spyridon Theodoropoulos | Allergy & Immunology | 2727 Midwest Drive, Onalaska, WI 54650 | 2008-10-08 |
| 1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
| 1902972896 | Maplewood Dental | Dentist | 1202 County Trunk Ph, Suite 300, Onalaska, WI 54650 | 2006-11-24 |
| 1245309327 | Benjamin John Breidenbach | Chiropractor | 1640 George St, Lacrosse, WI 54650 | 2006-11-06 |
| Find all providers in zip 54650 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033636071 | Erica Sauey | Counselor | 9532 E 16 Frontage Rd Ste 100, Onalaska, WI 54650-6742 | 2017-08-29 |
| 1467810028 | Laura Johnson | Counselor | 9532 E. 16 Frontage Rd, Ste. 100, Onalaska, WI 54650-6742 | 2016-02-10 |
| 1518158922 | Marina V Olsen | Counselor | 136 Rice Ln, Onalaska, WA 98570-9704 | 2007-08-09 |
| 1689616518 | Nicole Rene Johnson | Counselor | 704 Sand Lake Rd Ste 105, Onalaska, WI 54650-2456 | 2006-06-12 |
| 1316545452 | Kayla Fausti | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-10-12 |
| 1790319903 | Rebecca J Lamb | Counselor | 571 Braund St, Onalaska, WI 54650-8556 | 2020-02-26 |
| 1043843048 | Katlyn Becker | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-02-18 |
| 1093347650 | Aubryana Sullivan | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-02-11 |
| 1871131482 | Jennifer A Nichols | Counselor | 200 Mason St Ste 11, Onalaska, WI 54650-7061 | 2019-12-13 |
| 1336631233 | Caleb Aloisi | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2018-06-06 |
| Find all providers in ONALASKA | ||||
Please comment or provide details below to improve the information on KIMBERLY MARIA SHORTNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.