Individual
DENA JO NOWOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 639-9422
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 639-9422
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13420-33
WI
363LP2300X
Primary Care Nurse Practitioner
13420-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022007027
AMERICAN NURSES CREDENTIALING CENTER
—
Enumeration date
01/04/2023
Last updated
01/10/2023
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