SHANNON WALOWSKI


Address: 830 N 109th St Ste 1, Wauwatosa, WI 53226-3754
Phone: (414) 777-1811

SHANNON WALOWSKI (NPI# 1073056909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073056909
Entity Type Individual
Full Name SHANNON WALOWSKI
Credential MSN, APNP, AGPCNP-BC
Practice Address 830 N 109th St Ste 1
Wauwatosa
WI 53226-3754
Mailing Address 830 N 109th St
Ste 1
Wauwatosa
WI 53226-3754
Practice Telephone (414) 777-1811
Practice Fax Number 4147771812
Mailing Telephone (414) 777-1811
Mailing Fax Number 4147771812
Enumeration Date 2016-11-26
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 7131-33 WI Physician Assistants & Advanced Practice Nursing Providers
N 363LG0600X Nurse Practitioner
Specialization: Gerontology
7131-33 WI Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2405 Northwestern Ave, #ll30, Racine, WI 534042534 2622608370 2622608538

Office Location

Street Address 830 N 109TH ST STE 1
City WAUWATOSA
State WI
Zip Code 53226-3754

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255716783 Baljinder Kaur Nurse Practitioner 830 N 109th St Ste 1, Wauwatosa, WI 53226-3754 2015-07-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1912511155 Alexander Harlan Pharmacist 900 N 92nd St, Milwaukee, WI 53226 2020-09-04
1558985762 Armghan Haider Ans Student in an Organized Health Care Education/Training Program 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 2020-06-03
1669001103 Kimberly Tyler Student in an Organized Health Care Education/Training Program 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 2020-04-06
1972131993 Francesca Meloy Devine Student in an Organized Health Care Education/Training Program Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 2020-03-27
1285275248 Sharitta Alford Technician 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 2019-10-01
1619528023 Linda Marie Sabatinelli Technician 12107 W. Woodland Ave, Wauwatosa, WI 53226 2019-09-26
1598310195 Matthew Laviolette Surgery Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 2019-08-09
1962056432 Lyndsey Marie Bratberg Physician Assistant F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 2019-08-01
1659832855 Benjamin David Seadler Surgery Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 2019-03-29
1861953267 Michael Dryden Student in an Organized Health Care Education/Training Program 8701 Watertown Plank Rd., Milwaukee, WI 53226 2019-03-27
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306443460 Zhengqi Fan Nurse Practitioner 7850 Harwood Ave Unit 3, Wauwatosa, WI 53213-2561 2020-10-01
1578196770 Suzanne Girard Nurse Practitioner 2600 N Mayfair Rd Ste 545, Wauwatosa, WI 53226-1306 2020-02-15
1538723044 Mh Health Care Services, PC Nurse Practitioner 3300 N 124th St # W14, Wauwatosa, WI 53222-3106 2019-04-30
1932682473 Tracy A Bolton Nurse Practitioner 2626 N 76th St Ste 101, Wauwatosa, WI 53213 2018-09-11
1750892113 Karen Lynn Molitor Nurse Practitioner 2600 N. Mayfair Rd. Metropolitan Urology, Suite 545, Wauwatosa, WI 53226 2017-10-12
1255716783 Baljinder Kaur Nurse Practitioner 830 N 109th St Ste 1, Wauwatosa, WI 53226-3754 2015-07-27
1942637921 Robin Julianne-poedel Simon Nurse Practitioner 8320 W Bluemound Rd Ste 125, Wauwatosa, WI 53213-3367 2013-10-04
1437482403 Monica Teresa Bradtke Nurse Practitioner 10000 Blue Mound Rd, Wauwatosa, WI 53226 2009-09-09
1215993555 Angela M Paul Nurse Practitioner 10000 W Blue Mound Rd, Wauwatosa, WI 53226-4321 2006-04-25
1023617214 Holly C Helm Nurse Practitioner 10800 W Capitol Dr, Wauwatosa, WI 53222-1109 2020-10-20
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Competitor

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City WAUWATOSA
Zip Code 53226

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Dataset Information

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.

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