KIRBY ELIZABETH OTTO (NPI# 1649603044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649603044 |
| Entity Type | Individual |
| Full Name | KIRBY ELIZABETH OTTO |
| Other Name | KIRBY ELIZABETH KNAPMILLER |
| Credential | APNP |
| Practice Address |
100 County Road B Shawano WI 54166-7072 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9207318900 |
| Practice Fax Number | 9202251414 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457238 |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2020-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 156249-30 | WI | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 5477-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 744 S Webster Ave, Green Bay, WI 543013505 | 9204457226 | 9204457289 |
| 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 |
| 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 |
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700909413 | Deborah Jean Lidbury | Nurse Practitioner | 112 E Maurer St, Shawano, WI 54166-2942 | 2007-04-09 |
| 1457387474 | Lisa Schiller | Nurse Practitioner | 117 E Green Bay St, Shawano, WI 54166-2443 | 2006-06-23 |
| 1396104725 | Kathleen Marie Elertson | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2016-02-12 |
| 1528459070 | Janelle Schaal | Nurse Practitioner | 1346 E Green Bay St, Shawano, WI 54166-2210 | 2015-02-05 |
| 1649611930 | Diana J Scharine | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2013-07-15 |
| 1306182118 | Jason J Krueger | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2012-12-26 |
| 1942430996 | Sheila M Landon | Nurse Practitioner | 309 N Bartlett St, Shawano, WI 54166-2127 | 2009-07-23 |
| 1750510103 | Jill Olsen | Nurse Practitioner | 100 County Road B, Shawano, WI 54166-7072 | 2009-07-07 |
| 1558526269 | Ann M Papendorf | Nurse Practitioner | 100 County Road B, Shawano, WI 54166 | 2008-07-22 |
| 1013949122 | Veronica Gehrman | Nurse Practitioner | 117 E Green Bay St, Shawano, WI 54166-2443 | 2006-07-07 |
| Find all providers in SHAWANO | ||||
Please comment or provide details below to improve the information on KIRBY ELIZABETH OTTO.
| 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.