Individual
JEANIE FAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP, PTA
Contact information
Practice address
835 POTTS AVE, GREEN BAY, WI 54304-4535
(920) 491-9079
(920) 491-9082
Mailing address
835 POTTS AVE, GREEN BAY, WI 54304-4535
(920) 491-9079
(920) 491-9082
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
29227
NM
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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