Healthcare Provider Details

I. General information

NPI: 1376164194
Provider Name (Legal Business Name): MICHELLE K SCHARINE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE K MARIOTTI

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 N LAKE ST
NEENAH WI
54956-1439
US

IV. Provider business mailing address

1346 N LAKE ST
NEENAH WI
54956-1439
US

V. Phone/Fax

Practice location:
  • Phone: 775-338-0054
  • Fax:
Mailing address:
  • Phone: 775-338-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10091
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number197063
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: