Vandewettering, Angela R

Vandewettering, Angela R is an individual health care provider with primary practice located at 1111 Bayshore Dr , Manitowoc WI 54220-5548. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Vandewettering, Angela R can be contacted via phone (920) 682-6376.

Contact Information

Primary practice address
1111 Bayshore Dr Manitowoc WI 54220-5548
Phone: (920) 682-6376
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 14063 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14063-33 Wisconsin

Profile Details

NPI number 1124702220
LBN Legal business name Vandewettering, Angela R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2023
Last updated Jul 15th, 2026 - about 3 months 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 1124702220 NPPES
Wisconsin MEDICAID 100244004

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