Mr Conrad Shaker, RN is a
Registered Nurse based in La Valle, Wisconsin. Mr Conrad Shaker is licensed to practice in Wisconsin (license number 152058) and his current practice location is
110 S East St, La Valle, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(608) 415-1696.
NPI number for Mr Conrad Shaker is 1245481951 and his current mailing address is Po Box 352, La Valle, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1245481951.
Provider's Profile
| Full Name | Mr Conrad Shaker |
|---|
| Gender | Male |
|---|
| Speciality | Registered Nurse |
|---|
| Location | 110 S East St, La Valle, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1245481951
- Provider Enumeration Date: 10/01/2008
- Last Update Date: 10/01/2008
Medical Identifiers
Medical identifiers for Mr Conrad Shaker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245481951 | NPI | - | NPPES |
| 35011300 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 152058 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Conrad Shaker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Conrad Shaker, RN
Po Box 352,
La Valle, WI 53941-0352
Ph: (608) 415-1696 | Mr Conrad Shaker, RN
110 S East St,
La Valle, WI 53941-8525
Ph: (608) 415-1696 |
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