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

Tiffany Marie Boelk, APNP

Individual provider Family Nurse Practitioner · NPI 1700459690

Tiffany Marie Boelk, APNP is a Nurse Practitioner in Fond Du Lac, Wisconsin. Qualified in 2020, 6 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

420 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 923-7400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 145 N Main St, Fond Du Lac, WI 54935-3423 — (920) 926-8492
  • 835 Parkside St, Ripon, WI 54971-8505 — (920) 745-3520

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 10905-33 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 10905-33 (WI)

Record details

NPI number1700459690
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedJuly 20, 2021
Last updated in NPPESOctober 12, 2021
Certification dateOctober 12, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fond Du Lac