Individual
STEPHANIE PHILIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8208
(920) 288-3237
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 965-4055
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
194001
WI
363L00000X
Nurse Practitioner
10154
WI
363LF0000X
Family Nurse Practitioner
Primary
10154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111613
—
WI
Enumeration date
06/01/2015
Last updated
10/06/2022
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