Polfuss, Michele L

Polfuss, Michele L is an individual health care provider with primary practice located at Chw-Fox Valley Theda Clark Med Ctr 130 Second Street, Neenah WI 54956. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Polfuss, Michele L can be contacted via phone (920) 969-7900.

Contact Information

Primary practice address
Chw-Fox Valley Theda Clark Med Ctr 130 Second Street Neenah WI 54956
Phone: (920) 969-7900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 1628 Wisconsin

Profile Details

NPI number 1164476156
LBN Legal business name Polfuss, Michele L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Dec 18th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164476156 NPPES
Wisconsin MEDICAID 43972900
Wisconsin Other 007000261Y

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