Healthcare Provider Details

I. General information

NPI: 1437341385
Provider Name (Legal Business Name): CHRISTINE ANNETTE KLAWITER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE ANNETTE MUELLER NP-C

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W3208 VAN ROY RD
APPLETON WI
54915-4086
US

IV. Provider business mailing address

PO BOX 8003
APPLETON WI
54912-8003
US

V. Phone/Fax

Practice location:
  • Phone: 866-455-8111
  • Fax:
Mailing address:
  • Phone: 920-996-3200
  • Fax: 920-738-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number141919
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number141919
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: