Willison, Kim Marie

Willison, Kim Marie is an individual health care provider with primary practice located at 2105 E Enterprise Ave Ste 111, Appleton WI 54913. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Willison, Kim Marie can be contacted via phone (920) 731-6611.

Contact Information

Primary practice address
2105 E Enterprise Ave Ste 111 Appleton WI 54913
Phone: (920) 731-6611
Fax: (920) 731-6732
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2608 Wisconsin

Profile Details

NPI number 1225080955
LBN Legal business name Willison, Kim Marie
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jul 8th, 2007 - about 19 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 1225080955 NPPES
Wisconsin MEDICAID 41265800

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