SHANNON N SANDSTROM (NPI# 1194778324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194778324 |
| Entity Type | Individual |
| Full Name | SHANNON N SANDSTROM |
| Credential | NP |
| Practice Address |
137 Cambria St Randolph WI 53956 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9203265303 |
| Mailing Telephone | 9209268340 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2722 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
137 CAMBRIA ST |
| City | RANDOLPH |
| State | WI |
| Zip Code | 53956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811039761 | Consultants Laboratory of Wi, LLC | Clinical Medical Laboratory | 137 Cambria St, Randolph, WI 53956 | 2007-02-13 |
| 1770529828 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 137 Cambria St, Randolph, WI 53956 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336102169 | Melissa Elaine Lucarelli | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-04-11 |
| 1497832257 | Randolph Community Clinic Sc | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-11-01 |
| 1962052548 | Tessa Lindner | Physical Therapist | 502 N High St, Randolph, WI 53956-1117 | 2019-09-16 |
| 1245646645 | Rebecca Yelle | Occupational Therapist | 509 Williams St, Randolph, WI 53956-1122 | 2014-07-07 |
| 1003959529 | James Leslie Jones | Chiropractor | 175 Stark St, Randolph, WI 53956-1243 | 2007-02-14 |
| 1801955950 | Ross D Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2006-12-06 |
| 1356383822 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 107 N High St, Randolph, WI 53956-1267 | 2006-06-11 |
| 1457961971 | Myriel Jamae Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2020-08-10 |
| 1154711190 | Randolph Family Dental LLC | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2015-01-29 |
| 1326333006 | Michelle Dreger | Pharmacist | 107 N High St, Randolph, WI 53956-1267 | 2011-06-10 |
| Find all providers in zip 53956 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215197272 | Kim Perretta | Nurse Practitioner | 81 State Route 10, Randolph, NJ 07869-2430 | 2008-06-12 |
| 1073798666 | Sherry L Barnard | Nurse Practitioner | 2 S Main St Ste 3, Randolph, VT 05060-1367 | 2008-01-02 |
| 1356405435 | Rosemary Doherty Byrne | Nurse Practitioner | 1395 N Main St, Randolph, MA 02368-1768 | 2006-12-21 |
| 1063929149 | Heather Hogh | Nurse Practitioner | 765 Route 10 E Ste 201, Randolph, NJ 07869-1925 | 2018-01-10 |
| 1952688079 | Sally A Deeney | Nurse Practitioner | 765 Route 10 E, Suite 201, Randolph, NJ 07869-1925 | 2011-11-03 |
| 1184917437 | Angela Marie Giordano | Nurse Practitioner | 765 Route 10 E, Suite 201, Randolph, NJ 07869-1925 | 2011-05-19 |
| 1770894982 | Nancy Jameson Dreher | Nurse Practitioner | 765 Route 10 E, Randolph, NJ 07869-1925 | 2010-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952870289 | Sujata Karki | Nurse Practitioner | 402 N Eau Claire Ave Apt 309, Madison, WI 53705-2820 | 2018-11-15 |
| 1861926750 | Lisa Somers | Nurse Practitioner | W126n7338 Flint Dr, Menomonee Falls, WI 53051-4532 | 2017-04-17 |
| 1750828299 | Nanette Marie Kloth | Nurse Practitioner | 18110 W Bluemond Rd, Brookfield, WI 53045 | 2017-01-23 |
| 1902341852 | Rebecca Weld Hall | Nurse Practitioner | 3245 Milwaukee St, Madison, WI 53714-1829 | 2017-01-02 |
| 1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
| 1134574643 | Victoria White | Nurse Practitioner | 2500 N Mayfair Rd Ste 260, Wauwatosa, WI 53226-1443 | 2016-05-03 |
| 1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
| 1841673829 | M Christine Meulemans | Nurse Practitioner | 3391 Wilderness Trl, Suamico, WI 54313-8746 | 2015-07-08 |
| 1548659725 | Patricia Ann Kender | Nurse Practitioner | 17495 W. Capitol Dr., Brookfield, WI 53045 | 2015-01-12 |
| 1588062947 | Laura Swett | Nurse Practitioner | 733 Woodside Dr, Seymour, WI 54165-1661 | 2014-12-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.