Renee Frances Wautier, REGISTERED NURSE
Individual provider Active NPI Community Health Worker · Egg Harbor, WI
NPI 1356237341 · NPPES record last updated Jun 16, 2025
Key facts
- NPI
- 1356237341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- License
- 140279-030 (WI)
- Practice address
- 5046 Plum Bottom Rd
Egg Harbor, WI 54209-9147 - Phone
- (920) 619-5242
- NPI assigned
- Jun 16, 2025
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 140279-030 | WI | MD | Nursing Care Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | 140279-030 | WI | |
| General Practice Registered Nurse | 163WG0000X | 140279-030 | WI | |
| Nursing Care Agency | 251J00000X | 140279-030 | WI | |
| Community Health Worker | 172V00000X | 140279-030 | WI | Yes |
Addresses
Primary practice location
5046 Plum Bottom Rd
Egg Harbor, WI 54209-9147
Mailing address
5046 Plum Bottom Rd
Egg Harbor, WI 54209-9147
Phone (920) 619-5242
Other names
- Ms. Renee Frances Wautier
Other providers in Egg Harbor, WI
All providers in Egg Harbor, WI · Community Health Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.