Provider Demographics
NPI:1558400523
Name:KUETHER, CAROLYN (APNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:KUETHER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 MEADOW HILL DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1738
Mailing Address - Country:US
Mailing Address - Phone:715-232-9031
Mailing Address - Fax:
Practice Address - Street 1:800 WILSON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2734
Practice Address - Country:US
Practice Address - Phone:715-232-2388
Practice Address - Fax:715-232-1132
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1009-033363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1009-033OtherAPNP