Individual
NICOLE LYNNE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, CRNA
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Mailing address
N6065 COUNTY ROAD U, DE PERE, WI 54115-8903
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
236230-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
151951
WI
Other
Enumeration date
09/25/2023
Last updated
05/28/2024
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