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

Keelyn Marie Wallenfang, APNP

Individual provider Family Nurse Practitioner · NPI 1669198313

Keelyn Marie Wallenfang, APNP is a Nurse Practitioner in Appleton, Wisconsin. Qualified in 2022, 4 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1818 N Meade St
Appleton, WI 54911-3454
Phone: (920) 731-8900
Fax: (920) 738-5369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2502 S Ashland Ave, Green Bay, WI 54304-5252 — (920) 496-4700

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 12184 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 12184 (WI)

Record details

NPI number1669198313
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedOctober 14, 2022
Last updated in NPPESDecember 22, 2022
Certification dateDecember 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Appleton