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General NPI Number Information
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NPI Number | 1023086402
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Entity Type | Individual
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Provider Name | DORIS U THEUNE MS RN CS
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 2920 SUPERIOR AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-1944
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Country | US
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Telephone | 920-453-5414
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Fax | 920-803-2990
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Provider Business Mailing Address
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Address Line | 2920 SUPERIOR AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-1944
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Country | US
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Telephone | 920-453-5414
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Fax | 920-803-2990
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 249033
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License Number State | WI
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