Individual
PATRICIA M POLFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-9070
(920) 338-6820
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
278
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278-033
LICENSE
WI
Enumeration date
12/05/2005
Last updated
06/22/2017
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