Individual
ANGELA K GLEISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4088
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2583-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100010915
—
WI
01
—
2853-23
WI LICENSE
WI
Enumeration date
08/11/2010
Last updated
11/30/2023
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