Individual
MRS. LINDSEY WILSON KULBACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 364-3000
(920) 364-3900
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2613-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2613-23
WISCONSIN STATE LICENSE
WI
Enumeration date
07/01/2010
Last updated
03/17/2018
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