MEDICARE: AMIE NEUMAIER MARIE NEUMAIER 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
1	363LG0600X	Gerontology Nurse Practitioner	1357933	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1357933	OTHER	WI	WISCONSIN STATE LICENSE

General Provider Information

NPI Number	:	1568168920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE NEUMAIER MARIE NEUMAIER APNP

Provider Business Mailing Address
First Line	:	4717 DALE CURTIN DR
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-8958
Country	:	US
Telephone Number	:	608-838-1772
Fax Number	:

Provider Business Practice Location Address
First Line	:	4717 DALE CURTIN DR
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-8958
Country	:	US
Telephone Number	:	608-838-1772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/06/2023

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