Provider Demographics
NPI:1346640778
Name:RICHTER, ESTHER L (NP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:L
Last Name:RICHTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7210
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:301 BAY PARK SQUARE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5401
Practice Address - Country:US
Practice Address - Phone:920-592-9475
Practice Address - Fax:920-445-7229
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5936-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIF07141294OtherNP CERTIFICATION
WIK400197364Medicare Oscar/Certification
WIK400202949Medicare Oscar/Certification
WIF07141294OtherNP CERTIFICATION
WIK400221539Medicare Oscar/Certification