Individual
JULIE NIEDFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-6100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
157273-30
WI
367500000X
Certified Registered Nurse Anesthetist
209011022
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
5999-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100054128
—
WI
Enumeration date
11/08/2013
Last updated
04/17/2025
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