AMANDA NICOLE WALBRUN (NPI# 1063046761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063046761 |
| Entity Type | Individual |
| Full Name | AMANDA NICOLE WALBRUN |
| Practice Address |
100 County Road B Shawano WI 54166-7072 |
| Practice Telephone | 7155262111 |
| Mailing Telephone | 7155262111 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 COUNTY ROAD B |
| City | SHAWANO |
| State | WI |
| Zip Code | 54166-7072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260839 | Thedacare Medical Center - Shawano, Inc. | General Acute Care Hospital | 100 County Road B, Shawano, WI 54166-7072 | 2005-07-28 |
| 1053929653 | Jenna J Mulder | Student in an Organized Health Care Education/Training Program | 100 County Road B, Shawano, WI 54166-7072 | 2020-07-20 |
| 1730704420 | Katherine Dewane | Registered Nurse | 100 County Road B, Shawano, WI 54166-7072 | 2020-06-09 |
| 1952932972 | Kerry L Baird | Registered Nurse | 100 County Road B, Shawano, WI 54166-7072 | 2020-01-29 |
| 1417599804 | Calla J Scheel | Registered Nurse | 100 County Road B, Shawano, WI 54166-7072 | 2019-10-17 |
| 1649821760 | Thedacare Medical Center - Shawano, Inc. | Clinic/Center | 100 County Road B, Shawano, WI 54166-7072 | 2019-09-20 |
| 1477100477 | Cynthia M Bohringer | Registered Nurse | 100 County Road B, Shawano, WI 54166-7072 | 2019-08-23 |
| 1619523115 | Heather Kristine Elertson | Registered Nurse | 100 County Road B, Shawano, WI 54166-7072 | 2019-08-12 |
| 1164084760 | Matthew James Osborne | Physical Therapist | 100 County Road B, Shawano, WI 54166-7072 | 2019-07-03 |
| 1548744162 | Casey M Carroll | Speech-Language Pathologist | 100 County Road B, Shawano, WI 54166-7072 | 2018-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
| 1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
| 1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
| 1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
| 1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
| 1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
| 1114043387 | Thomas G Peterson | Optometrist | 150a County Road B, Shawano, WI 54166 | 2007-03-21 |
| 1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
| 1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
| Find all providers in zip 54166 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710465604 | Hannah E Miller | Physician Assistant | 100 County Road B, Shawano, WI 54166-7072 | 2018-08-01 |
| 1407362734 | Sarah Bauer | Physician Assistant | 100 County Road B, Shawano, WI 54166-7072 | 2017-12-22 |
| 1871004655 | Rebecca L Ketterhagen | Physician Assistant | 100 County Road B, Shawano, WI 54166 | 2017-10-19 |
| 1952684607 | Sharisa M Ruh | Physician Assistant | 309 N Bartlett St, Shawano, WI 54166-2127 | 2011-09-20 |
| 1053383232 | Jaclyn M Schechinger | Physician Assistant | 117 S Main St, Shawano, WI 54166-2357 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811409 | Kristen T Razner | Physician Assistant | 2500 E Capitol Dr # 3700, Appleton, WI 54911-8735 | 2020-11-03 |
| 1659986677 | Jordana Butler | Physician Assistant | 2105 E Enterprise Ave # 101, Appleton, WI 54913-7862 | 2020-09-15 |
| 1952916108 | Nicholas Allan Lueddecke | Physician Assistant | 101709 Fence Rd, Abbotsford, WI 54405-5400 | 2020-09-14 |
| 1073127049 | Dana Van De Hey | Physician Assistant | 616 White Birch Ct, Appleton, WI 54915-4516 | 2020-09-07 |
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1366055063 | Clai Bishop Catto | Physician Assistant | 902c Tainter St, Menomonie, WI 54751-1546 | 2020-08-24 |
| 1003434978 | Benjamin Alton Cuvelier | Physician Assistant | 132 Cambridge Ave Apt 407, Waukesha, WI 53188-4788 | 2020-07-08 |
| 1366060295 | Sarah Anne Cook | Physician Assistant | 850 Brinsmere Dr, Elm Grove, WI 53122-2101 | 2020-07-07 |
| 1275159428 | Breanna Evert | Physician Assistant | 2320 Parklawn Dr # C111, Waukesha, WI 53186-2954 | 2020-06-23 |
| 1376168443 | Sadie Kolodziej | Physician Assistant | 401 Dewey Dr, Stevens Point, WI 54482-9655 | 2020-06-14 |
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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.