| Doctor Name: | SHANA MCCLONE |
| NPI Number: | 1295144608 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5677-33 |
| Business Practice Address: | 5900 S Lake Dr Cudahy, WI - 531103171 |
| Business Phone Number: | 4144894048 |
| Business Fax Number: | 4144894153 |
| Mailing Address: | 8545 S Apple Creek Dr, OAK CREEK |
| State: | WI |
| Postal Code: | 531542633 |
| Phone Number: | 4144894048 |
| Fax Number: | 4144894153 |
| NPI Enumeration Date: | 08/11/2014 |
| NPI Last Update Date: | 08/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2200X |
| License Number: | 5677-33 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |