Individual
MARTA ROBIN BRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(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
118527
WI
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
807
WI
367A00000X
Advanced Practice Midwife
Primary
118527
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39905200
—
WI
Enumeration date
07/12/2006
Last updated
08/24/2011
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