Basic Information
| Provider Information | |||||||||
| NPI: | 1336281435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHELDON | ||||||||
| FirstName: | CURTIS | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | CRNA, MS APNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3305 N BALLARD RD | ||||||||
| Address2: | STE A | ||||||||
| City: | APPLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549119001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9202023363 | ||||||||
| FaxNumber: | 9209393827 | ||||||||
| Practice Location | |||||||||
| Address1: | 1818 N MEADE ST | ||||||||
| Address2: | |||||||||
| City: | APPLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549113454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9207314101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 01/03/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 96421-030 | WI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 43335000 | 05 | WI | MEDICAID |