Provider Demographics
NPI:1184006066
Name:WOEHLKE, DIANE M (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:M
Last Name:WOEHLKE
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3475 LEYNSE RD
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53085-2615
Mailing Address - Country:US
Mailing Address - Phone:920-838-3109
Mailing Address - Fax:
Practice Address - Street 1:N3475 LEYNSE RD
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN FALLS
Practice Address - State:WI
Practice Address - Zip Code:53085-2615
Practice Address - Country:US
Practice Address - Phone:920-838-3109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6409-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily