Individual
GINA M PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
835 S. VANBUREN ST., GREEN BAY, WI 54301-3526
(920) 433-0111
Mailing address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3575
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9520-33
WI
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
9520-33
WI
363LF0000X
Family Nurse Practitioner
9520
WI
Other
Enumeration date
08/26/2019
Last updated
08/05/2021
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