| Doctor Name: | MRS. NANCY A SHIRK |
| NPI Number: | 1003034216 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 962-132 |
| Business Practice Address: | 107 Division St Plymouth, WI - 530731801 |
| Business Phone Number: | 9208927788 |
| Business Fax Number: | 9208935459 |
| Mailing Address: | 8026 S 85th St, FRANKLIN |
| State: | WI |
| Postal Code: | 531328571 |
| Phone Number: | 4144254884 |
| Fax Number: | 4145252798 |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 962-132 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |