Healthcare Provider Details

I. General information

NPI: 1962733915
Provider Name (Legal Business Name): JULIE FRANCES KNETTER RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 N 3RD AVE
WAUSAU WI
54401-2965
US

IV. Provider business mailing address

719 N 3RD AVE
WAUSAU WI
54401-2965
US

V. Phone/Fax

Practice location:
  • Phone: 715-675-9858
  • Fax: 715-675-5475
Mailing address:
  • Phone: 715-675-9858
  • Fax: 715-675-5475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number131463-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: