Healthcare Provider Details

I. General information

NPI: 1568940401
Provider Name (Legal Business Name): UPLAND HILLS HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 QUAIL RIDGE DR
BARNEVELD WI
53507-9408
US

IV. Provider business mailing address

103 QUAIL RIDGE DR
BARNEVELD WI
53507-9408
US

V. Phone/Fax

Practice location:
  • Phone: 608-924-1088
  • Fax: 608-924-1087
Mailing address:
  • Phone: 608-924-1088
  • Fax: 608-924-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA A SCHNEDLER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 608-930-8000