Healthcare Provider Details

I. General information

NPI: 1083561153
Provider Name (Legal Business Name): NOELLE AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 HIGHWAY 14 EAST
RICHLAND CENTER WI
53581
US

IV. Provider business mailing address

408 DAVID CIR
ARENA WI
53503-9563
US

V. Phone/Fax

Practice location:
  • Phone: 608-647-8941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2335940
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: