Healthcare Provider Details

I. General information

NPI: 1548219132
Provider Name (Legal Business Name): TERESA R KIEVET RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA R SCHROEDER-KIEVET RN

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5624 LASALLE AVE
STEVENS POINT WI
54481-8588
US

IV. Provider business mailing address

5624 LASALLE AVE
STEVENS POINT WI
54481-8588
US

V. Phone/Fax

Practice location:
  • Phone: 715-295-0990
  • Fax:
Mailing address:
  • Phone: 715-295-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number114399
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: