| Doctor Name: | LISA RENEE SHIELDS |
| NPI Number: | 1265699698 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APNP-BC; GNP; MAN; |
| License Number: | 2544-033 |
| Business Practice Address: | 3410 East Schneider Avenue East Suite 3 Menomonie, WI - 54751 |
| Business Phone Number: | 7152333888 |
| Business Fax Number: | 7158382910 |
| Mailing Address: | 3410 East Schneider Avenue, East, Suite 3 MENOMONIE |
| State: | WI |
| Postal Code: | 54751 |
| Phone Number: | 7152333888 |
| Fax Number: | 7158382910 |
| NPI Enumeration Date: | 05/22/2008 |
| NPI Last Update Date: | 05/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2544-033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |