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NPI Code Detail

MEDICARE: VICKI L TETZLAFF APNP

MEDICARE: VICKI L TETZLAFF APNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1801WI

General Provider Information

NPI Number : 1538128954
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI L TETZLAFF APNP
Provider Business Mailing Address
First Line : 5800 W LAYTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4021
Country : US
Telephone Number : 262-532-3067
Fax Number :
Provider Business Practice Location Address
First Line : 5800 W LAYTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4021
Country : US
Telephone Number : 262-532-3067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 01/23/2023

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Directions to “ VICKI L TETZLAFF APNP” Practice Location

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