Shelby Lynn Spence, RN

Individual provider Active NPI Home Health Registered Nurse · Cochrane, WI

NPI 1659926699 · NPPES record last updated Aug 6, 2019

Key facts

NPI
1659926699
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
233786-30 (WI)
Practice address
107 Wisconsin Ave
Cochrane, WI 54622-7311
Phone
(715) 497-5222
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
233786-30WIMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 233786-30 WI Yes

Addresses

Primary practice location

107 Wisconsin Ave
Cochrane, WI 54622-7311

Mailing address

611 W Broadway St
Winona, MN 55987-2725
Phone (507) 429-7078

Other providers in Cochrane, WI

All providers in Cochrane, WI · Home Health Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.