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PAUL ANTONISSEN APNP
NPI 1174096747
Nurse Practitioner - Family in De Pere, WI

Active since January 07, 2019
3957 GARRETT ST, DE PERE, WI 54115(920) 471-3729 Get Directions Write a Review

NPPES record last updated: January 7, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paul Antonissen Apnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAUL ANTONISSEN APNP (NPI 1174096747) is an individual family provider in De Pere, Wisconsin, licensed in Wisconsin (8973-33) and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1174096747
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NamePAUL ANTONISSENCredential: APNP
Location Address3957 GARRETT STDe Pere, WI 54115-1655
Mailing Address3957 Garrett StDe Pere, WI 54115-1655 · (920) 471-3729
Phone(920) 471-3729
Sole ProprietorNo
Enumeration DateJanuary 7, 2019
✔ NPI 1174096747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WI · 8973-33
3957 GARRETT ST, De Pere, WI 54115
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Antonissen's NPI number?

The NPI number for Paul Antonissen is 1174096747. It was assigned to this individual provider in the NPPES registry on January 7, 2019.

Where is Paul Antonissen located?

Paul Antonissen practices at 3957 Garrett St, De Pere, WI 54115. The listed phone number is (920) 471-3729.

What is Paul Antonissen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Paul Antonissen was last updated on January 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.