Healthcare Provider Details

I. General information

NPI: 1609435692
Provider Name (Legal Business Name): KARI M STOCKHEIMER APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

IV. Provider business mailing address

6675 BUSINESS PKWY
ELKRIDGE MD
21075-6349
US

V. Phone/Fax

Practice location:
  • Phone: 833-967-0587
  • Fax:
Mailing address:
  • Phone: 715-701-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9453
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: