Provider Demographics
NPI:1639721871
Name:SHIFTING HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SHIFTING HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DENEYS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:920-621-9525
Mailing Address - Street 1:1702 SCHEURING RD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9567
Mailing Address - Country:US
Mailing Address - Phone:920-621-9525
Mailing Address - Fax:
Practice Address - Street 1:1702 SCHEURING RD
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9567
Practice Address - Country:US
Practice Address - Phone:920-621-9525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service