Individual
MRS. KRISTIAN NOELLE BASTRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APNP, FNP-BC
Contact information
Practice address
1855 S KOELLER ST, OSHKOSH, WI 54902-6186
(920) 223-7100
Mailing address
N9052 LILAC RD, MENASHA, WI 54952-8115
(920) 379-1073
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10195-33
WI
Other
Enumeration date
06/19/2020
Last updated
12/10/2020
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