Individual
MISS KIM A MITTELSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2500 E CAPITOL DR, SUITE 1700, APPLETON, WI 54911-8735
(920) 734-9600
(920) 734-4773
Mailing address
2500 E CAPITOL DR, SUITE 1700, APPLETON, WI 54911-8735
(920) 734-9600
(920) 734-4773
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3159-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710172614
—
WI
Enumeration date
09/13/2007
Last updated
04/29/2015
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