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General NPI Number Information
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NPI Number | 1023857679
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Entity Type | Individual
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Provider Name | HOLLY ANN BARTLEIN NP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1411 NORTH TAYLOR DR.
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City | SHEBOYGAN
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State | WI
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Zip | 53081
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Country | US
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Telephone | 920-457-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 1637 CHEYENNE AVE UNIT D
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City | GRAFTON
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State | WI
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Zip | 53024-9309
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Country | US
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Telephone | 920-946-3246
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15372-33
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License Number State | WI
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