DR. KIRSTIN M CERTALIC (NPI# 1275542326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275542326 |
| Entity Type | Individual |
| Full Name | DR. KIRSTIN M CERTALIC |
| Other Name | KIRSTIN MAUREEN CROWE |
| Credential | DO |
| Practice Address |
2315 E Moreland Blvd Westbrook Walk-in Clinic Waukesha WI 53186-2939 |
| Practice Telephone | 2625325800 |
| Practice Fax Number | 2625325760 |
| Mailing Telephone | 2625325800 |
| Mailing Fax Number | 2625325760 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2012-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 40646 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30091900 | 05 | |
| DEA NUMBER | BC6171932 | 01 | |
| WI | 1275542326 | 05 |
| Street Address |
2315 E MORELAND BLVD WESTBROOK WALK-IN CLINIC |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53186-2939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326011701 | Melissa A Kalt | Internal Medicine | 2315 E Moreland Blvd, Waukesha, WI 53186-2909 | 2006-02-08 |
| 1033633144 | Caitlin M Schueller | Nurse Practitioner | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2017-07-31 |
| 1912457680 | Elyse E Carrera | Nurse Practitioner | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2016-10-06 |
| 1780037317 | Jaclyn Amrita Devi Pillay | Family Medicine | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2016-07-19 |
| 1679938674 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2015-12-18 |
| 1417345208 | Jennifer Franz | Nurse Practitioner | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2014-12-31 |
| 1275831513 | Laurie B.d. Benkley | Registered Nurse | 2315 E Moreland Blvd, Westbrook Walk-in Clinic, Waukesha, WI 53186-2939 | 2011-03-10 |
| 1982929410 | Jillian Louise Ewing Haas | Internal Medicine | 2315 E Moreland Blvd, Westbrook Health Center, Waukesha, WI 53186-2939 | 2010-03-27 |
| 1447471677 | Aggeliki Zikos | Internal Medicine | 2315 E Moreland Blvd, Westbrook Health Center, Waukesha, WI 53186-2939 | 2007-05-02 |
| 1760502942 | Jeffrey Scott Nelson | Physician Assistant | 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2007-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
| 1881182889 | Allure Medical of Wisconsin Pllc | Clinic/Center | 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 | 2018-04-25 |
| 1316462104 | Mary B Mckee | Dietitian, Registered | 22370 W Bluemound Rd, #102, Waukesha, WI 53186 | 2017-08-14 |
| 1740738343 | Rebecca Menelle | Physical Therapist | 1809 Shepherd Ct, Apt 206, Waukesha, WI 53186 | 2016-09-13 |
| 1568919876 | Dianne Isnard | Physical Therapist | W231n1440 Corporate Court, Waukesha, WI 53186 | 2016-09-02 |
| 1982065991 | Brandon James Decker | Nurse Practitioner | 21775 Hillcrest Drive, Waukesha, WI 53186 | 2016-03-18 |
| 1598142937 | Sophia Marie Klingbiel | Social Worker | 1515 Paramount Dr., Waukesha, WI 53186 | 2015-05-06 |
| 1326478165 | Glen D Haberman | Dentist | 141 Wisconsin Avenue, Waukesha, WI 53186 | 2013-11-14 |
| 1487991014 | Sara Nicole Francis | Counselor | 217 Wisconsin Ave Ste 211, Waukesha, WI 53186 | 2013-01-16 |
| 1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
| Find all providers in zip 53186 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306376314 | Eric Paul Kuehn | Family Medicine | 210 Nw Barstow St Ste 210, Waukesha, WI 53188-3771 | 2017-06-13 |
| 1427504802 | Paladina Health, LLC | Family Medicine | 402 Travis Ln, #67, Waukesha, WI 53189-5011 | 2016-08-26 |
| 1720440019 | Heather Koch Harrison | Family Medicine | 210 Nw Barstow St Ste 201, Waukesha, WI 53188-3771 | 2016-03-24 |
| 1174535470 | Punnoose Mackiel | Family Medicine | 1240 Ridge Rd, Waukesha, WI 53186-1425 | 2006-08-13 |
| 1851300933 | Glenn Toth | Family Medicine | 403 N Grand Ave, Waukesha, WI 53186-4913 | 2006-08-06 |
| 1689647406 | Caryn A. Brownell | Family Medicine | 2130 Big Bend Road, Prohealth Care Medical Associates, Inc., Waukesha, WI 53189-7624 | 2006-02-10 |
| 1902879737 | Madelyn C Sieraski | Family Medicine | Prohealth Care Medical Centers-south, 2130 Big Bend Road, Waukesha, WI 53189 | 2006-02-10 |
| 1699747394 | Sandra G Amadon | Family Medicine | 240 Maple Ave, Prohealth Care Medical Associates Inc., Waukesha, WI 53149-8475 | 2006-02-06 |
| 1669457214 | Eduardo Scholcoff | Family Medicine | 210 Nw Barstow St, Suite 201, Waukesha, WI 53188-3771 | 2005-12-07 |
| 1710971668 | Robert J Beaumont | Family Medicine | 237 Wisconsin Ave, Waukesha, WI 53186-4955 | 2005-09-07 |
| Find all providers in WAUKESHA | ||||
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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.