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Individual

DEBRA KNISBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITONER

Contact information

Practice address
626 FOXTAIL DR, HARTFORD, WI 53027-2743
(262) 224-4649
Mailing address
626 FOXTAIL DR, HARTFORD, WI 53027-2743
(262) 224-4649

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6991-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6991-33
STATE OF WISCONSIN
WI
Enumeration date
06/10/2016
Last updated
06/10/2016
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