Individual
MRS. BONNIE GENE GLINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3263 EATON RD, GREEN BAY, WI 54311-6830
(920) 433-6000
(920) 433-6009
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1936
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1068129
NCCPA CERTIFICATION #
WI
01
—
1936-023
STATE LICENSE NUMBER
WI
05
—
42878400
—
WI
Enumeration date
07/13/2006
Last updated
01/06/2020
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