Provider Demographics
NPI:1124207469
Name:KIEFNER, JULIE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:KIEFNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54937-1059
Mailing Address - Country:US
Mailing Address - Phone:920-251-3181
Mailing Address - Fax:
Practice Address - Street 1:419 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:NORTH FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-1059
Practice Address - Country:US
Practice Address - Phone:920-251-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI118203-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health