Provider Demographics
NPI:1912683053
Name:MAYER, SHELBY JUNE
Entity Type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:JUNE
Last Name:MAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W55N190 WOODMERE CT APT 2
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2840
Mailing Address - Country:US
Mailing Address - Phone:414-801-9476
Mailing Address - Fax:
Practice Address - Street 1:W55N190 WOODMERE CT APT 2
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2840
Practice Address - Country:US
Practice Address - Phone:414-801-9476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic