Healthcare Provider Details

I. General information

NPI: 1609283076
Provider Name (Legal Business Name): ADRIANA M SIEHR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 REED AVE
MANITOWOC WI
54220-2026
US

IV. Provider business mailing address

601 REED AVE
MANITOWOC WI
54220-2026
US

V. Phone/Fax

Practice location:
  • Phone: 920-682-8841
  • Fax:
Mailing address:
  • Phone: 920-682-8841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5841
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5841-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: