Provider Demographics
NPI:1932726510
Name:FUERSTENAU, SHAYLYN
Entity Type:Individual
Prefix:
First Name:SHAYLYN
Middle Name:
Last Name:FUERSTENAU
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 1:3344 E ALLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-1016
Mailing Address - Country:US
Mailing Address - Phone:414-881-5515
Mailing Address - Fax:
Practice Address - Street 1:3409 N DOWNER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2934
Practice Address - Country:US
Practice Address - Phone:414-229-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program