Provider Demographics
NPI:1881982619
Name:SCHEEL, SHANE A (RN)
Entity type:Individual
Prefix:MR
First Name:SHANE
Middle Name:A
Last Name:SCHEEL
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 1:331 17TH ST N
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-3708
Mailing Address - Country:US
Mailing Address - Phone:715-252-5998
Mailing Address - Fax:
Practice Address - Street 1:331 17TH ST N
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-3708
Practice Address - Country:US
Practice Address - Phone:715-252-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168319-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse