Koss, Shannon L

Koss, Shannon L is an individual health care provider with primary practice located at 1531 S Madison St , Appleton WI 54915. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Koss, Shannon L can be contacted via phone (920) 996-3700.

Contact Information

Primary practice address
1531 S Madison St Appleton WI 54915
Phone: (920) 996-3700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1604 Wisconsin

Profile Details

NPI number 1861583007
LBN Legal business name Koss, Shannon L
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jan 18th, 2022 - about 4 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 1861583007 NPPES
Wisconsin MEDICAID 41978400

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