Provider Demographics
NPI:1699883900
Name:KREITLOW, SHARLENE PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:SHARLENE
Middle Name:PATRICIA
Last Name:KREITLOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARLENE
Other - Middle Name:PATRICIA
Other - Last Name:FRITSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 W STOUT ST
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-5000
Mailing Address - Country:US
Mailing Address - Phone:715-236-8100
Mailing Address - Fax:715-236-8104
Practice Address - Street 1:1700 W STOUT ST
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-5000
Practice Address - Country:US
Practice Address - Phone:715-236-8100
Practice Address - Fax:715-236-8104
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36610207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32142200Medicaid
WI32142200Medicaid
WIK400356580Medicare PIN