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General NPI Number Information
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NPI Number | 1154259885
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Entity Type | Individual
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Provider Name | EMILEE MOOTZ RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 2607 N 18TH ST
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City | WAUSAU
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State | WI
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Zip | 54403-3176
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Country | US
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Telephone | 715-261-0713
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Fax |
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Provider Business Mailing Address
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Address Line | 2607 N 18TH ST
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City | WAUSAU
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State | WI
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Zip | 54403-3176
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Country | US
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Telephone | 715-261-0713
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 230475-30
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License Number State | WI
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