=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528916624
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALTERNATIVE APPROACH WELLNESS CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2026
-----------------------------------------------------
Last Update Date | 03/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1011 CENTER AVE
-----------------------------------------------------
City | OOSTBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53070-1355
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-564-4299
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1011 CENTER AVE
-----------------------------------------------------
City | OOSTBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53070-1355
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-564-4299
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RN
-----------------------------------------------------
Name | ASHLEY BOSS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 920-564-4299
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WN1003X
-----------------------------------------------------
Taxonomy Name | Nutrition Support Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------