Provider Demographics
NPI:1811006752
Name:SCHWARTAU, PAMELA S (CFNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:SCHWARTAU
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:S
Other - Last Name:TROKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3600 TOWER AVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-5337
Mailing Address - Country:US
Mailing Address - Phone:715-392-1955
Mailing Address - Fax:715-392-1935
Practice Address - Street 1:3600 TOWER AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5337
Practice Address - Country:US
Practice Address - Phone:715-392-1955
Practice Address - Fax:715-392-1935
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNDUL 015R3SCOtherMEDICA
MNPREFERRED ONEOtherNA9591046229
MNR081494-0OtherLICENSE RN
MN0340580-22OtherLICENSES CFNP
WI81823OtherLICENSE RN
WI1596OtherLICENSE WI
WI01-13076OtherMEDICA - WI
MN01-13077OtherMEDICA - MN
WI43936900Medicaid
WI585985645005OtherBCBS-WI
WI585985645005OtherBCBS-WI