ANNETTE S HARRIS (NPI# 1053839571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053839571 |
| Entity Type | Individual |
| Full Name | ANNETTE S HARRIS |
| Other Name | ANNETTE S GOLTZ |
| Credential | NP |
| Practice Address |
12203 Corporate Pkwy Mequon WI 53092-3388 |
| Practice Telephone | 2623878239 |
| Mailing Telephone | 2623878239 |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2018-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 8133 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154661346 | Annette Suzanne Harris | Occupational Therapy Assistant | 3111 Heatherdowns Blvd, Toledo, OH 43614-3832 | 2013-02-25 |
| 1245392711 | Annette Harris | Occupational Therapist | 55 Alison Dr Ste 1, Alexander City, AL 35010-4409 | 2006-12-14 |
| 1013942804 | Annette C Harris | Social Worker | 10478 Fair Oaks, Columbia, MD 21044-4141 | 2006-07-11 |
| 1003114885 | Annette Kay Harris | Registered Nurse | 744 Riggs Cir, Davenport, FL 33897-8537 | 2011-03-03 |
| 1053521724 | Annette Mae Harris | Occupational Therapist | 315 8th St, Lincoln, IL 62656-2671 | 2007-05-23 |
| 1164547618 | Annette Marie Harris | Social Worker | 444 Angell St, Providence, RI 02906-4445 | 2007-03-20 |
| 1003979899 | Annette Harris | Specialist | 7505 Main St, Suite 300, Houston, TX 77030-4520 | 2006-12-19 |
| Street Address |
12203 CORPORATE PKWY |
| City | MEQUON |
| State | WI |
| Zip Code | 53092-3388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235058 | East Mequon Surgery Center LLC | Clinic/Center | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2005-09-19 |
| 1477187649 | Andrew M Oswald | Physician Assistant | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2020-02-26 |
| 1174018584 | Ashley A Mcguire | Family Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2018-06-27 |
| 1568843696 | Mikhail Eiseler | Family Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2015-06-15 |
| 1548640774 | Brant Michael Balthazor | Physician Assistant | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2015-06-03 |
| 1720499759 | Ryan William Clark | Pain Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2014-05-13 |
| 1316382211 | Heidi Rae Schmidt | Physician Assistant | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2013-05-06 |
| 1285966101 | Kristin M Shtulberg | Registered Nurse | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2010-02-02 |
| 1487894267 | Joe Lipp Jr. | Specialist/Technologist, Other | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2009-03-06 |
| 1063680593 | Pamela Lee | Registered Nurse | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2008-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
| 1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
| 1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
| 1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
| 1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
| 1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
| 1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
| Find all providers in zip 53092 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851713739 | Sheila A Reynolds | Nurse Practitioner | 11300 N Revere Rd, Mequon, WI 53092-3555 | 2014-01-13 |
| 1861737108 | Sarah J Escareno | Nurse Practitioner | 6400 W Enterprise Dr Fl 1, Mequon, WI 53092-4400 | 2012-11-27 |
| 1194830257 | Melody A Fowlkes | Nurse Practitioner | 12122 N Rolling Field Dr, Mequon, WI 53097-2766 | 2006-08-20 |
| 1083681332 | Kristen E Lachapell | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2006-03-07 |
| 1508306671 | Philip W Diperna | Nurse Practitioner | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2017-03-08 |
| 1851833735 | Vyacheslav Dubrovsky | Nurse Practitioner | 1317 W Towne Square Rd, Mequon, WI 53092-5017 | 2016-11-09 |
| 1326417874 | Crystal M Steinhardt | Nurse Practitioner | 11270 N Port Washington Rd, Mequon, WI 53092-3410 | 2015-09-15 |
| 1770968521 | Patricia Kay Nelson | Nurse Practitioner | 13133 N Port Washington Rd, Suite G-18, Mequon, WI 53097-2419 | 2015-07-22 |
| 1477947935 | Britani R Weidman | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2015-03-23 |
| 1336540418 | Andrea R Enters | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2014-09-09 |
| Find all providers in MEQUON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.