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General NPI Number Information
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NPI Number | 1730381591
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Entity Type | Individual
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Provider Name | PAMELA J THUL-IMMLER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9060 MADELINE LAKE RD
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City | WOODRUFF
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State | WI
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Zip | 54568-9651
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Country | US
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Telephone | 715-358-5066
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Fax | 715-358-5480
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Provider Business Mailing Address
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Address Line | 9060 MADELINE LAKE RD
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City | WOODRUFF
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State | WI
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Zip | 54568-9651
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Country | US
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Telephone | 715-358-5066
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Fax | 715-358-5480
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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 | 1370-033
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | WI
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