MR. EVAN RICHARD MULDER (NPI# 1356745640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356745640 |
| Entity Type | Individual |
| Full Name | MR. EVAN RICHARD MULDER |
| Credential | DAT, LAT, OTC |
| Practice Address |
501 N 10th St Manitowoc WI 54220 |
| Mailing Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 9206826376 |
| Practice Fax Number | 9206520115 |
| Mailing Telephone | 9204909046 |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2019-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1554-39 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1554-39 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 155 Radio Dr, Woodbury, MN 551252619 | 9208318742 |
| Street Address |
501 N 10TH ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699744730 | Jonathon Charles Henry | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-03-14 |
| 1962036830 | Kellie Greenwood | Registered Nurse | 501 N 10th St, Manitowoc, WI 54220-4039 | 2020-02-28 |
| 1275173072 | Saralyn Schleis | Specialist/Technologist, Other | 501 N 10th St, Manitowoc, WI 54220-4039 | 2020-01-09 |
| 1801310818 | Margaret Jane Konopasek | Physician Assistant | 501 N 10th St, Manitowoc, WI 54220-4039 | 2017-08-01 |
| 1023541547 | Andrea Cook | Occupational Therapist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2017-04-11 |
| 1538538319 | Nichole Olson | Specialist/Technologist, Other | 501 N 10th St, Manitowoc, WI 54220-4039 | 2015-09-22 |
| 1164836201 | Stacey L Hladish | Physician Assistant | 501 N 10th St, Manitowoc, WI 54220 | 2014-06-17 |
| 1639441785 | Stephanie L Mccabe | Physical Therapist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2012-02-06 |
| 1609028422 | Jason G De Vries | Podiatrist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2008-10-13 |
| 1902082456 | Kimberly Sullivan | Specialist/Technologist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2008-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780234583 | Grahmby Pratt | Specialist/Technologist | 857 N 11th St, Manitowoc, WI 54220-3308 | 2019-09-13 |
| 1609269752 | Janice Hamachek | Specialist/Technologist | 1139 S 17th St, Manitowoc, WI 54220-5023 | 2015-03-13 |
| 1336532480 | Katelin Dorow | Specialist/Technologist | 5017 Remiker Ln, Manitowoc, WI 54220-1073 | 2015-03-13 |
| 1104217926 | Kevin Teutschmann | Specialist/Technologist | 2424 Mirro Dr, Apartment 5, Manitowoc, WI 54220-6746 | 2015-02-16 |
| 1407917883 | Milton Leganchuk | Specialist/Technologist | 2719 Calumet Ave, Manitowoc, WI 54220-5546 | 2006-12-12 |
| 1003278813 | Blaine Anthony Birtzer | Specialist/Technologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2016-03-22 |
| 1477922250 | Brady Schrauth | Specialist/Technologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2015-09-22 |
| 1750782652 | Anna Mielke | Specialist/Technologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2014-09-10 |
| 1316278518 | Kyle Ralph Rabuck | Specialist/Technologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2010-01-27 |
| 1295960821 | Bethany Hannon | Specialist/Technologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2009-05-27 |
| Find all providers in MANITOWOC | ||||
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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.