Provider Demographics
NPI:1265310221
Name:MULDER, ANNELIESE KARIN (RN, MIDWIFE)
Entity type:Individual
Prefix:
First Name:ANNELIESE
Middle Name:KARIN
Last Name:MULDER
Suffix:
Gender:F
Credentials:RN, MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OPHIEM
Mailing Address - State:IL
Mailing Address - Zip Code:61468-9506
Mailing Address - Country:US
Mailing Address - Phone:309-230-9883
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST
Practice Address - Street 2:
Practice Address - City:OPHIEM
Practice Address - State:IL
Practice Address - Zip Code:61468-9506
Practice Address - Country:US
Practice Address - Phone:309-230-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife