Healthcare Provider Details

I. General information

NPI: 1841126711
Provider Name (Legal Business Name): DRIFTLESS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 1/2 S MAIN ST STE 3
VIROQUA WI
54665-1667
US

IV. Provider business mailing address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

V. Phone/Fax

Practice location:
  • Phone: 608-315-2833
  • Fax: 608-389-8554
Mailing address:
  • Phone: 608-315-2833
  • Fax: 608-389-8554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JACOB SCHULTZ
Title or Position: OWNER
Credential: APNP
Phone: 608-315-2833