Healthcare Provider Details

I. General information

NPI: 1457059735
Provider Name (Legal Business Name): HEALTHCARE ACCESS POINT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W2721 BROOKHAVEN DR
APPLETON WI
54915-8184
US

IV. Provider business mailing address

1 INDIANA SQ STE 2060
INDIANAPOLIS IN
46204-2020
US

V. Phone/Fax

Practice location:
  • Phone: 920-423-3438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDRE CREESE
Title or Position: CEO
Credential: MD
Phone: 800-526-6797