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Individual

AMANDA HACKBARTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
618 MEMORIAL DR, CHILTON, WI 53014-1568
(920) 849-3800
Mailing address
618 MEMORIAL DR, CHILTON, WI 53014-1568
(920) 849-3800

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
6774-33
WI

Other

Enumeration date
01/08/2016
Last updated
05/14/2021
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