Individual
JACQUELYN MARIE ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
725 S WEBSTER AVE STE 201, GREEN BAY, WI 54301-3500
(920) 430-7100
(920) 430-7114
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15553-33
WI
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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