Individual
GESINA JH THIRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4070 EQUESTRIAN LN, GREEN BAY, WI 54229-9649
(920) 866-6100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 866-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77797
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219357
—
WI
Enumeration date
03/20/2019
Last updated
07/25/2023
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