Individual
TEASHA L KAEPERNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2291
(920) 531-2207
Mailing address
1405 MILL ST, PO BOX 65, NEW LONDON, WI 54961-2155
(920) 531-2291
(920) 531-2207
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2038
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42890800
—
WI
01
—
P00391342
RAILROAD
WI
Enumeration date
08/01/2006
Last updated
07/30/2012
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