Most Relevant Information
Provider Data
| NPI Number: | 1003674896 |
| Provider Name: | SHANDELL LEE HERRICK FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 246761-30 |
Most Important Dates
| Enumeration Date: | 03/07/2024 |
| Last Updated: | 03/07/2024 |
Provider Practice Location
125 HOSPITAL DR
WATERTOWN
WI
530983303
Practice Location Phone/Fax
| Phone: | 2623259309 |
| Fax: |
Provider Mailing Location
500 MARY KNOLL LN
WATERTOWN
WI
530981219
Provider Mailing Phone/Fax
| Phone: | 2623259309 |
| Fax: |