Provider Demographics
NPI:1912478835
Name:HUEBSCHMAN, KAELYN E (APNP)
Entity Type:Individual
Prefix:
First Name:KAELYN
Middle Name:E
Last Name:HUEBSCHMAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:KAELYN
Other - Middle Name:E
Other - Last Name:FREIBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-389-2233
Mailing Address - Fax:
Practice Address - Street 1:1242 W FOND DU LAC ST
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-9288
Practice Address - Country:US
Practice Address - Phone:920-745-4700
Practice Address - Fax:715-256-3039
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8995363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily