Individual provider · Type 1 NPI
Shalyn Fuller
Adult Care Home Facility · Waukesha, WI
NPI number
1124977012
Active
Practice location
3610 Shade Tree Ct
Waukesha, WI 53188-9573
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1124977012
Shalyn Fuller's National Provider Identifier is 1124977012, issued on Jan 24, 2026. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Waukesha, WI. The record was last updated on Jan 24, 2026.