Individual
MRS. KASEY LYNN BANTES-BEHMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2502 S. ASHLAND AVE., GREEN BAY, WI 54304
(920) 496-4700
Mailing address
2502 S. ASHLAND AVE., GREEN BAY, WI 54304
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2415-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003667
—
WI
Enumeration date
04/22/2009
Last updated
10/18/2023
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