Individual
SHARON THERESE LILLGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-7411
Mailing address
W2153 LAU RD, KAUKAUNA, WI 54130-9229
(920) 788-0881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
120815-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
50742
WI
Other
Enumeration date
03/28/2007
Last updated
08/22/2019
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