Provider Demographics
NPI:1053740761
Name:RINGENOLDUS, LYNN ANNETTE (APNP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ANNETTE
Last Name:RINGENOLDUS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:A
Other - Last Name:BERGLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 GROVE AVE
Mailing Address - Street 2:P.O. BOX 314
Mailing Address - City:WILD ROSE
Mailing Address - State:WI
Mailing Address - Zip Code:54984-6901
Mailing Address - Country:US
Mailing Address - Phone:920-622-5560
Mailing Address - Fax:920-622-6021
Practice Address - Street 1:701 GROVE AVE
Practice Address - Street 2:
Practice Address - City:WILD ROSE
Practice Address - State:WI
Practice Address - Zip Code:54984-6901
Practice Address - Country:US
Practice Address - Phone:920-622-5560
Practice Address - Fax:920-622-6021
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5510-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner