Healthcare Provider Details

I. General information

NPI: 1295080646
Provider Name (Legal Business Name): KATHLEEN JEAN HILLESHEIM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN JEAN EASTMAN APNP

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 GREENBRIER RD
GREEN BAY WI
54311-6519
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 920-288-8000
  • Fax:
Mailing address:
  • Phone: 800-326-2250
  • Fax: 920-433-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4883
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4883-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: