Healthcare Provider Details

I. General information

NPI: 1053774737
Provider Name (Legal Business Name): AMANDA RUPLINGER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA SCHRAUFNAGEL

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N2670 COUNTY ROAD AY
BROWNSVILLE WI
53006-1127
US

IV. Provider business mailing address

N2670 COUNTY ROAD AY
BROWNSVILLE WI
53006-1127
US

V. Phone/Fax

Practice location:
  • Phone: 920-517-6382
  • Fax:
Mailing address:
  • Phone: 920-517-6382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number320089-31
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: