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Individual

JENNIFER N. CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2793 LINEVILLE RD, GREEN BAY, WI 54313-7152
(920) 496-4700
Mailing address
2793 LINEVILLE RD, GREEN BAY, WI 54313-7152
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
168869
WI
363L00000X
Nurse Practitioner
Primary
6649-33
WI

Other

Enumeration date
09/17/2015
Last updated
10/14/2015
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