Healthcare Provider Details

I. General information

NPI: 1508942541
Provider Name (Legal Business Name): JANE ANTOINETTE NOVITZKE APNP, RN, NHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANE ANTOINETTE SELLERS RN, NHA

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 4TH AVE S
PARK FALLS WI
54552-1922
US

IV. Provider business mailing address

1133 4TH AVE S POST OFFICE BOX 110
PARK FALLS WI
54552-1922
US

V. Phone/Fax

Practice location:
  • Phone: 715-762-4600
  • Fax: 715-762-2835
Mailing address:
  • Phone: 715-762-4600
  • Fax: 715-762-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113 - 033
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number113 - 033
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number113 - 033
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number113 - 033
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: