Individual
TIFFANY JO SCHRAUFNAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 738-4600
(920) 738-4792
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55263-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450030803
MEDICARE PTAN
WI
01
—
711290199
MEDICARE PTAN
WI
Enumeration date
04/28/2009
Last updated
02/25/2013
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