Kelsey Hinterleitner

Individual provider Active NPI Other Specialist/Technologist · Woodruff, WI

NPI 1154077949 · NPPES record last updated Feb 10, 2024

Key facts

NPI
1154077949
Entity type
Individual (NPI type 1)
Primary specialty
Other Specialist/Technologist 246Z00000X
License
6580-403 (WI)
Practice address
103 Elm St
Woodruff, WI 54568-9100
Phone
(715) 661-0639
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1003312WIMDDental Hygienist
6580-403WIMDOther Specialist/Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 1003312 WI
Other Specialist/Technologist
Group: 193400000X SINGLE SPECIALTY GROUP
246Z00000X 6580-403 WI Yes

Addresses

Primary practice location

103 Elm St
Woodruff, WI 54568-9100

Mailing address

1280 Arrowhead Dr
Arbor Vitae, WI 54568-9701
Phone (715) 661-0639

Other names

  • Kelsey Chiolino Former name

Other providers in Woodruff, WI

All providers in Woodruff, WI · Other Specialist/Technologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.