Provider Demographics
NPI:1861959371
Name:MULZER, TERESA A (APNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:MULZER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:A
Other - Last Name:BESAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1716 LAWRENCE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9108
Mailing Address - Country:US
Mailing Address - Phone:920-276-8600
Mailing Address - Fax:920-632-6806
Practice Address - Street 1:1716 LAWRENCE DR STE 103
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9108
Practice Address - Country:US
Practice Address - Phone:920-276-8600
Practice Address - Fax:920-632-6806
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9071-33363LF0000X
WI9071363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100088577Medicaid