Provider Demographics
NPI:1962052118
Name:GERMAIN, AMY (DNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:J
Other - Last Name:BARTELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 E BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1514
Mailing Address - Country:US
Mailing Address - Phone:920-257-6378
Mailing Address - Fax:
Practice Address - Street 1:1411 N TAYLOR DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3043
Practice Address - Country:US
Practice Address - Phone:920-457-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9619-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily