Individual
NICOLE LEE DEMBROSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 490-9046
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
177942
WI
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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