Provider Demographics
NPI:1184459281
Name:NATZKE, ALISHA MARLEY (APNP)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:MARLEY
Last Name:NATZKE
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 1:249 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54768-1309
Mailing Address - Country:US
Mailing Address - Phone:715-456-7507
Mailing Address - Fax:
Practice Address - Street 1:6 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:OWEN
Practice Address - State:WI
Practice Address - Zip Code:54460-9534
Practice Address - Country:US
Practice Address - Phone:715-229-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15871-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily