Healthcare Provider Details

I. General information

NPI: 1306384268
Provider Name (Legal Business Name): KRISTEN N RUSSELL APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN N SCHMITZ NP

II. Dates (important events)

Enumeration Date: 02/10/2017
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 E CAPITOL DR
APPLETON WI
54911-2790
US

IV. Provider business mailing address

3 NEENAH CTR
NEENAH WI
54956-3070
US

V. Phone/Fax

Practice location:
  • Phone: 920-830-5292
  • Fax:
Mailing address:
  • Phone: 920-830-5900
  • Fax: 920-830-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-028806
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7518
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: