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
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922016690 | NPPES |
| Other | 13487 | DEAN HEALTH PLAN HMO | |
| MEDICAID | 1922016690 | DEAN HEALTH PLAN HMO |
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