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Individual

MRS. KRISTIN M SHTULBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, APN

Contact information

Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
(262) 387-8239
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.405240
IL
163W00000X
Registered Nurse
171140-30
WI
363L00000X
Nurse Practitioner
Primary
6230
WI
363LF0000X
Family Nurse Practitioner
6230
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100043192
WI
05
1285966101
WI
Enumeration date
02/02/2010
Last updated
02/27/2024
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