SHELLEY FLASCH (NPI# 1417497710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417497710 |
| Entity Type | Individual |
| Full Name | SHELLEY FLASCH |
| Credential | APNP |
| Practice Address |
3400 Market Ln Kenosha WI 53144-3430 |
| Mailing Address |
6308 8th Ave Attn: Medical Staff Office Kenosha WI 53143-5031 |
| Practice Telephone | 2625514600 |
| Practice Fax Number | 2625514630 |
| Mailing Telephone | 2626563313 |
| Mailing Fax Number | 2626535850 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
7547-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEA | MF4242323 | 01 |
| WI | WI LICENSE - APNP | 7547-33 | 01 |
| Street Address |
3400 MARKET LN |
| City | KENOSHA |
| State | WI |
| Zip Code | 53144-3430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154377091 | Keven R Mottinger | Physician Assistant | 3400 Market Ln, Kenosha, WI 53144-3430 | 2006-05-25 |
| 1083261226 | Amanda Quinonez | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2019-08-22 |
| 1629534813 | Heather Nicole Thomas | Registered Nurse | 3400 Market Ln, Kenosha, WI 53144-3430 | 2019-02-13 |
| 1922573625 | Tarren Prange | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2018-10-09 |
| 1891260543 | Stephanie M Brown | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2018-10-09 |
| 1790297331 | Juli Marie Degrave | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2017-11-03 |
| 1750800884 | Christos Reppas | Physician Assistant | 3400 Market Ln, Kenosha, WI 53144-3430 | 2017-09-09 |
| 1194193813 | Sandra Homan | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2015-09-11 |
| 1326452921 | Rebekah Costello | Family Medicine | 3400 Market Ln, Kenosha, WI 53144-3430 | 2014-06-12 |
| 1710306725 | Christine T Adique | Nurse Practitioner | 3400 Market Ln, Kenosha, WI 53144-3430 | 2014-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410202 | Dpt Holdings LLC | Occupational Therapist | 3825 39th Ave #110, Kenosha, WI 53144 | 2020-09-03 |
| 1225641392 | Eunice Boatin | Social Worker | Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 | 2020-08-28 |
| 1881250256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3621 Market Lane, Kenosha, WI 53144 | 2019-05-11 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1174992721 | Claire Ann Adams | Acupuncturist | 5416 52nd Street, Kenosha, WI 53144 | 2015-09-24 |
| 1285017087 | Jessica Lynn Gillengerten | Acupuncturist | 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 | 2015-06-30 |
| 1750704656 | Amanda Kay Kreuzer | Occupational Therapy Assistant | 3109 30th Ave, Kenosha, WI 53144 | 2014-01-28 |
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1124326764 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3710 57th Ave, Kenosha, WI 53144 | 2011-03-07 |
| 1982931291 | Roman Bilak | General Practice | 4126 - 7th Street, Kemosha, WI 53144 | 2009-11-06 |
| Find all providers in zip 53144 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952957987 | Hun Hee Han | Nurse Practitioner | 6125 Green Bay Rd Ste 200, Kenosha, WI 53142-2945 | 2019-08-15 |
| 1689127086 | Jennifer Donna Ouweneel | Nurse Practitioner | 3520 30th Ave, Wheaton Franciscan Healthcare Clinic, Kenosha, WI 53144-1619 | 2016-08-02 |
| 1669713319 | Rebecca Shawn Swenson | Nurse Practitioner | 4777 88th Ave, Kenosha, WI 53144-7439 | 2013-03-05 |
| 1932394764 | Annmarie D Wendorf | Nurse Practitioner | 6308 8th Ave # 3040, Kenosha, WI 53143-5031 | 2007-09-14 |
| 1083236715 | Krista Ann Tappa | Nurse Practitioner | 8600 Sheridan Rd, Kenosha, WI 53143-6506 | 2020-05-15 |
| 1063031045 | Guadalupe Orlando Romero | Nurse Practitioner | 4777 88th Ave, Kenosha, WI 53144-7439 | 2020-04-10 |
| 1518595230 | Anne Nudi | Nurse Practitioner | 1400 75th St, Kenosha, WI 53143-1544 | 2020-03-29 |
| 1205476603 | Drew Velasco | Nurse Practitioner | 6121 Green Bay Rd, Kenosha, WI 53142-2926 | 2020-01-14 |
| 1518509413 | Jennifer E Armstrong | Nurse Practitioner | 7401 104th Ave Ste 110, Kenosha, WI 53142-7845 | 2019-10-11 |
| 1336798685 | Krystal Marie Rafenstein | Nurse Practitioner | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2019-09-10 |
| Find all providers in KENOSHA | ||||
Please comment or provide details below to improve the information on SHELLEY FLASCH.
| 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.