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NPI Code Detail

MEDICARE: LOUISE A BERNDT FNP C

MEDICARE: LOUISE A BERNDT FNP C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner1484 033WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033106430
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUISE A BERNDT FNP C
Provider Business Mailing Address
First Line : PO BOX 22487
Second Line :
City : GREEN BAY
State : WI
Zip : 54305-2487
Country : US
Telephone Number : 920-445-7226
Fax Number :
Provider Business Practice Location Address
First Line : 744 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3505
Country : US
Telephone Number : 920-445-7226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 12/15/2015

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