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1508801622
SHANNON M FOGARTY
WAUWATOSA, WI
NPI
1508801622
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Former Name
SHANNON M WHITAKER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: WI 1545-033)
Enumeration Date
2006-06-20
Last Update Date
2021-11-18
Business Address
SHANNON M FOGARTY N.P.
1055 N MAYFAIR RD
WAUWATOSA, WI 53226
Phone number: 414-479-2300
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Mailing Address
SHANNON M FOGARTY N.P.
1055 N MAYFAIR RD
WAUWATOSA, WI 53226-3436
Phone number: 414-479-2300
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