Provider Demographics
NPI:1811336050
Name:MESS, SHAWNA ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:ROSE
Last Name:MESS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:ROSE
Other - Last Name:SCHANTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1200 OAKLEAF WAY
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720
Mailing Address - Country:US
Mailing Address - Phone:715-832-1400
Mailing Address - Fax:715-832-4187
Practice Address - Street 1:1200 OAKLEAF WAY STE A
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-2245
Practice Address - Country:US
Practice Address - Phone:715-832-1400
Practice Address - Fax:715-832-4187
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3126-23363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant