Provider Demographics
NPI:1548058449
Name:SCHULTE-CAMPBELL, THERESA AURELIA
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:AURELIA
Last Name:SCHULTE-CAMPBELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 COUNTY RD S
Mailing Address - Street 2:
Mailing Address - City:SOBIESKI
Mailing Address - State:WI
Mailing Address - Zip Code:54171-9782
Mailing Address - Country:US
Mailing Address - Phone:920-822-1380
Mailing Address - Fax:920-822-1381
Practice Address - Street 1:6090 COUNTY RD S
Practice Address - Street 2:
Practice Address - City:SOBIESKI
Practice Address - State:WI
Practice Address - Zip Code:54171-9782
Practice Address - Country:US
Practice Address - Phone:920-822-1380
Practice Address - Fax:920-822-1381
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant