Individual
NICOLE LEE SPAETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
140167
WI
363LF0000X
Family Nurse Practitioner
Primary
2699-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41270100
—
WI
Enumeration date
07/18/2006
Last updated
06/20/2008
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