SHANNON GODBOLT

KENOSHA, WI
NPI1497228712
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WI  7384)
Enumeration Date2019-01-09
Last Update Date2019-01-09
Business Address
SHANNON GODBOLT APNP
6308 8TH AVE # 3030
KENOSHA, WI 53143-5031
Phone number: 262-656-3600
Mailing Address
SHANNON GODBOLT APNP
6308 8TH AVE # 3030
KENOSHA, WI 53143-5031
Phone number: 262-656-3600
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