Provider Demographics
NPI:1740610260
Name:DOLLINGER, KRISTY L (DNP, APNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:L
Last Name:DOLLINGER
Suffix:
Gender:F
Credentials:DNP, APNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-1503
Mailing Address - Country:US
Mailing Address - Phone:262-473-4548
Mailing Address - Fax:262-472-7691
Practice Address - Street 1:1305 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-1503
Practice Address - Country:US
Practice Address - Phone:262-473-4548
Practice Address - Fax:262-472-7691
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI200247-30163W00000X
WI13252-33363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1740610260Medicaid