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Individual

KRYSTINA L PUTNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1580 COMMANCHE AVE, GREEN BAY, WI 54313-5751
(920) 435-8326
(920) 430-4659
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
230464
WI
363LF0000X
Family Nurse Practitioner
Primary
9859
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F01200323
AMERICAN ACADEMY OF NURSE PRACTITIONERS
Enumeration date
01/28/2020
Last updated
02/06/2023
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