Provider Demographics
NPI:1851909410
Name:AMUGHMUN, SHEMIAH (RN)
Entity Type:Individual
Prefix:
First Name:SHEMIAH
Middle Name:
Last Name:AMUGHMUN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7822 W VILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3513
Mailing Address - Country:US
Mailing Address - Phone:414-484-5192
Mailing Address - Fax:414-455-3214
Practice Address - Street 1:7822 W VILLARD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-3513
Practice Address - Country:US
Practice Address - Phone:414-484-5192
Practice Address - Fax:414-455-3214
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI232433163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty