Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Menominee Indian Tribe of Wisconsin

Organization Family Medicine Physician · NPI 1568404721

Menominee Indian Tribe of Wisconsin is a Family Medicine Physician in Keshena, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

W3275 Wolf River Rd
Keshena, WI 54135
Phone: (715) 799-3361
Fax: (715) 799-3099
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Federally Qualified Health Center (FQHC) Taxonomy 261QF0400X

Record details

NPI number1568404721
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Waukau — Health Administrator · (715) 799-3361
Other names Menominee Tribal Clinic; Menominee Tribal Clinic
NPI enumeratedJune 12, 2006
Last updated in NPPESApril 2, 2019
Mailing addressPo Box 970, Keshena, WI 54135-0970

Other providers in Keshena