Individual
ANNEMARIE UPHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, PMHNP-BC, CNM
Contact information
Practice address
1531 S MADISON ST, APPLETON, WI 54915-1800
(920) 730-4411
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6092-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
6092
WI
367A00000X
Advanced Practice Midwife
148901-32
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033362066
—
WI
01
—
12792
AMERICAN MIDWIFERY CERTIFICATION
—
Enumeration date
11/04/2008
Last updated
11/16/2021
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