Healthcare Provider Details

I. General information

NPI: 1427007723
Provider Name (Legal Business Name): BARBARA J SCHLITTLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S CENTURY AVE
WAUNAKEE WI
53597-2386
US

IV. Provider business mailing address

1300 S CENTURY AVE
WAUNAKEE WI
53597-2386
US

V. Phone/Fax

Practice location:
  • Phone: 608-849-4315
  • Fax: 608-850-1606
Mailing address:
  • Phone: 608-849-4315
  • Fax: 608-850-1606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number469-023
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: