Healthcare Provider Details

I. General information

NPI: 1336053198
Provider Name (Legal Business Name): KAREN MARIE TRZEBIATOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 HOOVER AVE
PLOVER WI
54467-2330
US

IV. Provider business mailing address

6131 STATE HIGHWAY 54
PLOVER WI
54467-9758
US

V. Phone/Fax

Practice location:
  • Phone: 715-345-5424
  • Fax: 715-345-7354
Mailing address:
  • Phone: 715-345-5424
  • Fax: 715-345-7354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number158627
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: