Hadija Shaa
Individual provider Active NPI Licensed Vocational Nurse · Deforest, WI
NPI 1902695679 · NPPES record last updated May 1, 2025
Key facts
- NPI
- 1902695679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- LP60836920 (WA)
- Practice address
- 4958 Innovation Dr Apt 301
Deforest, WI 53532-2838 - Phone
- (425) 540-8132
- NPI assigned
- May 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP60836920 | WA | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | LP60836920 | WA | Yes |
Addresses
Primary practice location
4958 Innovation Dr Apt 301
Deforest, WI 53532-2838
Mailing address
4958 Innovation Dr Apt 301
Deforest, WI 53532-2838
Other providers in Deforest, WI
- Kelly Schultz
- Amanda Schulz
- Allison Schumacher
- Crystal Schuster
- Eileen Cheryl Schutte
- Aimee Shaw
- Valerie Sherwood
- Lisa A. Simpson
- Source of Care
- Speech With Tara, LLC
All providers in Deforest, WI · Licensed Vocational Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.