Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 902-025 | WI |
Y | 222Z00000X | Podiatrist | 902-025 | WI |
N | 213ES0103X | Foot & Ankle Surgery | 902-025 | WI |
NPI | 1043210594 |
---|---|
Provider Name | Dr. Theresa Lynn Schinke |
First Address | Appleton, WI 54911-8426 |
Second Address | Appleton, WI 54911-8426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 04/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43239600 | (05) | WI |
BS9222718 | DEA (01) | WI |
V05256 | (02) | WI |