Ketevan Shonia

NPI #1518642271 in Merrill, Wisconsin

Provider Information

NPI Number: 1518642271
Entity Type: Individual
Name: Ketevan Shonia
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Jun 20, 2023
Last Updated: Sep 3, 2025

Practice Location

Address: 3333 E MAIN ST
City: Merrill
State: Wisconsin
ZIP Code: 54452-8959
Phone: (715) 539-5600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Physician Assistant	363A00000X	Primary

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