Shauna Lee Kofoed

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

148381 Issued in WI

Practice address

860 N 18TH St
Manitowoc, WI 54220-3131

Phone

(414) 708-6119

NPI assigned

Jul 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1720713753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 N 18TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203131",
            "telephone_number": "414-708-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 N 18TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203131",
            "telephone_number": "414-708-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFOED",
        "first_name": "SHAUNA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "148381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "148381",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nurseshauna@gmail.com",
            "affiliation": "N",
            "address_1": "860 N 18th St",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542203131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip Knier, M.ED
• Matthew Koeberl, M.D.
• Susan F Koehler, APNP
• Alecia G Koenig
• Koenig, Inc
• Leah Marie Kohlmann, RN
• Erin Marie Kolar, PT
• Gregory Mathew Kolar, MS ED
• Patricia Kolbe
• Jennifer Lee Kolonich, P.T.

• Registered Nurse in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.