Healthcare Provider Details

I. General information

NPI: 1972584324
Provider Name (Legal Business Name): NANCY A MCLAUGHLIN APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY A WLODAREZYK

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 12/26/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 N 23RD ST
SHEBOYGAN WI
53081-3171
US

IV. Provider business mailing address

1222 N 23RD ST
SHEBOYGAN WI
53081-3171
US

V. Phone/Fax

Practice location:
  • Phone: 920-457-6800
  • Fax:
Mailing address:
  • Phone: 920-457-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2352
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2352033
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number092889-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: