Johnsen, Shelly L

Johnsen, Shelly L is an individual health care provider with primary practice located at 3509 Dewey St , Manitowoc WI 54220. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Johnsen, Shelly L can be contacted via phone (920) 686-5731.

Contact Information

Primary practice address
3509 Dewey St Manitowoc WI 54220
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45814020 Wisconsin

Profile Details

NPI number 1922016690
LBN Legal business name Johnsen, Shelly L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Sep 4th, 2018 - about 8 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 1922016690 NPPES
Other 13487 DEAN HEALTH PLAN HMO
MEDICAID 1922016690 DEAN HEALTH PLAN HMO

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