Carmona Moses, Shannon K

Carmona Moses, Shannon K is an sole proprietor health care provider with primary practice located at 4855 S Moorland Rd Fl 3 , New Berlin WI 53151-7494. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Carmona Moses, Shannon K can be contacted via phone (262) 432-7599.

Contact Information

Primary practice address
4855 S Moorland Rd Fl 3 New Berlin WI 53151-7494
Phone: (262) 432-7599
Fax: (262) 432-7694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 4680-33 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4680-033 Wisconsin

Profile Details

NPI number 1932485489
LBN Legal business name Carmona Moses, Shannon K
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 28th, 2011
Last updated Jun 18th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932485489 NPPES
Wisconsin MEDICAID 1932485489

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