Healthcare Provider Details

I. General information

NPI: 1356742233
Provider Name (Legal Business Name): JUTTA DEININGER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US

IV. Provider business mailing address

400 RENAISSANCE CTR STE 2600
DETROIT MI
48243-1599
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11159
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number11159
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number4704426517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: