HEATHER KRISTINE ELERTSON (NPI# 1619523115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619523115 |
| Entity Type | Individual |
| Full Name | HEATHER KRISTINE ELERTSON |
| Credential | NP |
| Practice Address |
100 County Road B Shawano WI 54166-7072 |
| Mailing Address |
122 E College Ave Appleton WI 54911-5741 |
| Practice Telephone | 7155242161 |
| Practice Fax Number | 7155263461 |
| Mailing Telephone | 9209963264 |
| Mailing Fax Number | 9208305910 |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2020-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 229489-30 | WI | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9485-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| W2035 Auburn Ashford Dr, Campbellsport, WI 530103138 | 2623051877 |
| 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 |
| 1063046761 | Amanda Nicole Walbrun | Physician Assistant | 100 County Road B, Shawano, WI 54166-7072 | 2020-03-03 |
| 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 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235645870 | Ann Renae Thornock | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2017-12-19 |
| 1467810770 | Kary L Cappaert | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2016-02-01 |
| 1104104561 | Angela M Parmentier | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2011-08-02 |
| 1619082021 | Krista Cornelius | Nurse Practitioner | 100 County Road B, Shawano, WV 54166 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203857 | Tiera Manuel | Nurse Practitioner | 3956 N 28th St, Milwaukee, WI 53216-2637 | 2020-10-22 |
| 1801494778 | Tajana Jovicic | Nurse Practitioner | 3157 S 66th St, Milwaukee, WI 53219-4105 | 2020-10-13 |
| 1497352090 | Carlotta Williams | Nurse Practitioner | 1205 Juniper Ln, Oconomowoc, WI 53066-3100 | 2020-10-06 |
| 1932706611 | Rachel Sullivan | Nurse Practitioner | 304 E Northlawn Dr, Cottage Grove, WI 53527-8917 | 2020-10-05 |
| 1649877663 | Kirk O'hanison | Nurse Practitioner | 1020 Oconomowoc Pkwy Unit B, Oconomowoc, WI 53066-4616 | 2020-10-02 |
| 1780291401 | Carlie Dell | Nurse Practitioner | 1636 Industrial Pkwy N, Marinette, WI 54143-3703 | 2020-09-27 |
| 1093320459 | Tyronda T Gray | Nurse Practitioner | 5833 N 117th St, Milwaukee, WI 53225-2207 | 2020-09-12 |
| 1629683065 | Yia Lor | Nurse Practitioner | 3750 Summerset Way Apt 1, Oshkosh, WI 54901-0501 | 2020-09-11 |
| 1245844364 | Asia Ann Gomez | Nurse Practitioner | 2816 E Allison Ave, Cudahy, WI 53110-2541 | 2020-09-04 |
| 1861005837 | Clair Roser Rivera | Nurse Practitioner | 3734 W Ohio Ave, Milwaukee, WI 53215-4047 | 2020-08-28 |
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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.