Tabitha Christine Uitenbroek, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11593-33 Issued in WI

Practice address

4090 N Orion LN
Appleton, WI 54913-7619

Phone

(920) 427-9873

NPI assigned

Nov 30, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 19, 2022 through Jan 19, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1467110148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 N ORION LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137619",
            "telephone_number": "920-427-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 N ORION LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137619",
            "telephone_number": "920-427-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UITENBROEK",
        "first_name": "TABITHA",
        "middle_name": "CHRISTINE",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11593-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise L Turnmeyer, RN MS
• Twelvestone Infusion Centers LLC
• Emily Tymos
• Summer Uchacz, RN,BSN
• Brittany Uitenbroek, AU.D.
• Amanda Jane Ujazdowski, PA-C
• Peter F Ullrich Jr., MD
• Mehgan L Ullsperger, MSN, APNP, AGNP-C
• Kaitlyn Marie Ulrich, LPC-IT
• Umoja Health Services

• Family Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.