Individual
JILL M WITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1346 E GREEN BAY ST, SHAWANO, WI 54166-2210
(715) 526-6244
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
123577-030
WI
363L00000X
Nurse Practitioner
Primary
3442-33
WI
363LF0000X
Family Nurse Practitioner
3442-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123577-30
WISCONSIN RN LICENSE
WI
01
—
3442-33
WISCONSIN LICENSE
WI
05
—
36084900
—
WI
Enumeration date
04/02/2008
Last updated
12/31/2025
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