Provider Demographics
NPI:1164316196
Name:ARENDT, ALEXANDRIA (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:ARENDT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 SHIRLEY RD
Mailing Address - Street 2:
Mailing Address - City:DENMARK
Mailing Address - State:WI
Mailing Address - Zip Code:54208-8605
Mailing Address - Country:US
Mailing Address - Phone:920-655-2599
Mailing Address - Fax:
Practice Address - Street 1:2300 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-3712
Practice Address - Country:US
Practice Address - Phone:920-320-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIF05251044363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily