Individual
MRS. COLLEEN M VAN EGEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
715 SUPERIOR RD, SUITE 120, GREEN BAY, WI 54311-7594
(920) 406-9803
Mailing address
2700 E ENTERPRISE AVE, STE A, APPLETON, WI 54913-7656
(920) 406-9803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2178-023
WI
Other
Enumeration date
09/20/2007
Last updated
03/07/2023
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