MARY LOU ROETHEL (NPI# 1083927412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083927412 |
| Entity Type | Individual |
| Full Name | MARY LOU ROETHEL |
| Credential | MSN,NP-C,APNP |
| Practice Address |
1621 N Taylor Dr Suite 300 Sheboygan WI 53081-1990 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2011-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4078-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1621 N TAYLOR DR SUITE 300 |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081-1990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699761403 | Katharine A Donohue | Nurse Practitioner | 1621 N Taylor Dr, Suite 300, Sheboygan, WI 53081-1990 | 2005-09-27 |
| 1568862324 | Anne Clarke | Nurse Practitioner | 1621 N Taylor Dr, Sheboygan, WI 53081-1990 | 2014-08-29 |
| 1942628623 | Stacy Miller | Nurse Practitioner | 1621 N Taylor Dr, Suite 100, Sheboygan, WI 53081-1990 | 2014-03-31 |
| 1467740126 | Donna Mayer | Nurse Practitioner | 1621 N Taylor Dr, #300, Sheboygan, WI 53081-1990 | 2011-07-15 |
| 1114215886 | Laura Alsteen | Nurse Practitioner | 1621 N Taylor Dr, Suite 300, Sheboygan, WI 53081-1990 | 2011-07-15 |
| 1972804854 | David Beimborn | Physical Therapist | 1621 N Taylor Dr, Suite 300, Sheboygan, WI 53081-1990 | 2010-11-09 |
| 1275799413 | St. Nicholas Hospital of The Hospital Sisters of St Francis | Hospitalist | 1621 N Taylor Dr, Sheboygan, WI 53081-1990 | 2008-08-06 |
| 1528232576 | Marla Z Wolfert | Internal Medicine | 1621 N Taylor Dr, Sheboygan, WI 53081-1990 | 2008-04-21 |
| 1265604839 | Dawn C. Baarendse | Nurse Practitioner | 1621 N Taylor Dr, Sheboygan, WI 53081-1990 | 2008-03-24 |
| 1326220823 | Hospice and Palliative Care Consultants | Internal Medicine | 1621 N Taylor Dr, Sheboygan, WI 53081-1990 | 2007-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
| Find all providers in zip 53081 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720133895 | Rhonda M Zimmermann | Nurse Practitioner | 615 Pennsylvania Ave, Sheboygan, WI 53081 | 2007-01-25 |
| 1699761403 | Katharine A Donohue | Nurse Practitioner | 1621 N Taylor Dr, Suite 300, Sheboygan, WI 53081-1990 | 2005-09-27 |
| 1699299347 | Kia Lee Vang | Nurse Practitioner | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2017-08-02 |
| 1841742004 | Lisa Martis | Nurse Practitioner | 3711 S Taylor Dr, Suite 104, Sheboygan, WI 53081-8495 | 2016-11-03 |
| 1336691062 | Kerry Ann Talbert | Nurse Practitioner | 924 N Taylor Dr, Sheboygan, WI 53081 | 2016-10-28 |
| 1366833188 | Elizabeth Lynn Merry | Nurse Practitioner | 3711 S Taylor Dr, Sheboygan, WI 53081-8495 | 2015-02-16 |
| 1114317419 | Donna Buechner | Nurse Practitioner | 510 S 8th St, Sheboygan, WI 53081-4404 | 2015-01-26 |
| 1275943243 | St Nicholas Hospital-sisters of The Third Order of St Francis | Nurse Practitioner | 3100 Superior Ave, Sheboygan, WI 53081-1948 | 2014-04-30 |
| 1306199435 | Kate M Ratajczak | Nurse Practitioner | 1703 N Taylor Dr, Sheboygan, WI 53081-1933 | 2012-10-26 |
| 1356693071 | Barbara Jean Lukas | Nurse Practitioner | 615 Pennsylvania Ave, Sheboygan, WI 53081-4663 | 2012-10-04 |
| Find all providers in SHEBOYGAN | ||||
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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.