Individual provider Active NPI

Lynnae Shaw, RN BSN NCSN

  • School Registered Nurse
  • Waupun, WI
National Provider Identifier
1417889270
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
132102-30 Issued in WI
Practice address
801 E Lincoln St
Waupun, WI 53963-1753
Phone
(920) 324-5591
Fax
(920) 939-7674
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WS0200X 132102-30 WI Primary

Addresses

Primary practice location

801 E Lincoln St
Waupun, WI 53963-1753

Mailing address

801 E Lincoln St
Waupun, WI 53963-1753
Phone (920) 324-5591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
132102-30WIMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1417889270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E LINCOLN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631753",
            "telephone_number": "920-324-5591",
            "fax_number": "920-939-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E LINCOLN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631753",
            "telephone_number": "920-324-5591",
            "fax_number": "920-939-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LYNNAE",
        "credential": "RN BSN NCSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, School",
            "state": "WI",
            "license": "132102-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupun, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.