Individual
MICHELLE A PEVONKA-THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
128 NORTHBREEZE DR, APPLETON, WI 54911-1225
(920) 944-4443
(920) 968-7707
Mailing address
128 NORTHBREEZE DR, APPLETON, WI 54911-1225
(920) 944-4443
(920) 968-7707
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
123478-30
WI
Other
Enumeration date
06/05/2012
Last updated
03/04/2017
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