Individual
THERESA M WROLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2845 GREENBRIER RD STE 230, GREEN BAY, WI 54311-6519
(920) 288-8250
(920) 288-8255
Mailing address
2845 GREENBRIER RD STE 230, PO BOX 8900, GREEN BAY, WI 54308-8900
(920) 288-8250
(920) 288-8255
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
119101
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062730001
DIAMOND ID
WI
01
—
1062730002
DIAMOND ID
WI
01
—
1062730003
DIAMOND ID
WI
Enumeration date
08/12/2006
Last updated
09/30/2008
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