Provider Demographics
NPI:1114288727
Name:KOEHLER, JANET LEE
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:KOEHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3111 SAWER CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-6362
Mailing Address - Country:US
Mailing Address - Phone:920-303-9744
Mailing Address - Fax:
Practice Address - Street 1:3111 SAWYER CREEK DR
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6362
Practice Address - Country:US
Practice Address - Phone:920-303-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11761930163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse