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Contact Information

SHANNON GAINES
23323 87TH ST
SALEM, WI53168-9437
 Phone: 262-977-0070
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for SHANNON GAINES · (Female)

NPI Number 1780414060
Status Active
Credentials
Entity Individual
Enumeration date 08/02/2024
Last updated 08/02/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 041.527344
  • WI License # 234239-30
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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