Individual
DEBRA A WOLLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3220 CROCKER AVE, SHEBOYGAN, WI 53081-6434
(920) 694-4745
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8900
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100085879
—
WI
Enumeration date
01/23/2019
Last updated
02/26/2025
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