Provider Demographics
NPI:1659857977
Name:MAASS, AMY M (APNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:MAASS
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 1:2124 KOHLER MEMORIAL DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3174
Mailing Address - Country:US
Mailing Address - Phone:920-204-6758
Mailing Address - Fax:
Practice Address - Street 1:1616 N CASALOMA DR SUITE 100
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8245
Practice Address - Country:US
Practice Address - Phone:920-204-6758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8660-33363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily