Provider Demographics
NPI:1649292772
Name:SZCZEPANSKI, SHERRI CLAIRE (APNP)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:CLAIRE
Last Name:SZCZEPANSKI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 DOUSMAN STREET
Mailing Address - Street 2:PREVEA HEALTH
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:920-272-1011
Practice Address - Street 1:1727 SHAWANO AVE.
Practice Address - Street 2:PREVEA HEALTH
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54307-3008
Practice Address - Country:US
Practice Address - Phone:920-272-1010
Practice Address - Fax:920-272-1011
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI116807163W00000X
WI2805363A00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36000600Medicaid
WI36000600Medicaid
Q68030Medicare UPIN