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Contact Information

KIRSTEN J ANTONNEAU, PAC
1300 S GREEN BAY RD STE 100
MOUNT PLEASANT, WI53406-4469
 Phone: 262-619-4191
 Fax: 262-634-5185
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KIRSTEN J ANTONNEAU · (Female)

NPI # 1467526400
Status Active
Credentials PAC
Entity Individual
Enumeration date 11/20/2006
Last updated 09/10/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1981
  • WI License # 1981-23
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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