PAUL ANTONISSEN APNP NPI 1174096747

NPI Information

NPI: 1174096747
Provider Name: PAUL ANTONISSEN, APNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
3957 GARRETT ST
DE PERE, WI
ZIP 54115
Phone: (920) 471-3729
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Paul Antonissen, APNP is a family nurse practitioner in De Pere, WI. Paul Antonissen, APNP NPI is 1174096747. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3957 GARRETT ST
DE PERE, WI
ZIP 54115-655
Phone: (920) 471-3729

The enumeration date for this NPI number is 1/7/2019 and was last updated on 1/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	8973-33	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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