Individual
ELLA PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16048-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100293353
—
WI
Enumeration date
10/11/2024
Last updated
12/20/2024
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