Provider Demographics
NPI:1508526252
Name:SHULFER, CAIDEN CHAD (RN)
Entity Type:Individual
Prefix:MR
First Name:CAIDEN
Middle Name:CHAD
Last Name:SHULFER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-9277
Mailing Address - Country:US
Mailing Address - Phone:920-544-6895
Mailing Address - Fax:
Practice Address - Street 1:3171 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-9277
Practice Address - Country:US
Practice Address - Phone:920-544-6895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI249954163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse