Provider Demographics
NPI:1942297387
Name:ORWIG, CAROL L (FNPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:ORWIG
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7210
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:441 FRENCH ST
Practice Address - Street 2:
Practice Address - City:PESHTIGO
Practice Address - State:WI
Practice Address - Zip Code:54157-1203
Practice Address - Country:US
Practice Address - Phone:715-582-9949
Practice Address - Fax:715-582-4464
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1097033363LF0000X
MI4704384077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43867900Medicaid
0270843OtherAMERICAN NURSES CREDENTIALING CENTER
WI500018072OtherRR-MEDICARE
S48075Medicare UPIN
WI002240165Medicare Oscar/Certification
WIK400334512Medicare Oscar/Certification
WI43867900Medicaid