Amanda L Muehlbauer, RN

Individual provider Active NPI Registered Nurse · Brillion, WI

NPI 1497195077 · NPPES record last updated Jun 27, 2013

Key facts

NPI
1497195077
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
195909 - 30 (WI)
Practice address
W985 Hacker Rd Apt 5
Brillion, WI 54110-9158
Phone
(920) 810-1792
NPI assigned
Jun 27, 2013
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
195909 - 30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 195909 - 30 WI Yes

Addresses

Primary practice location

W985 Hacker Rd Apt 5
Brillion, WI 54110-9158

Mailing address

W985 Hacker Rd Apt 5
Brillion, WI 54110-9158
Phone (920) 810-1792

Other providers in Brillion, WI

All providers in Brillion, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.