Individual
JENNIFER BEA RESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2920 NICOLET DR, SS 1400, GREEN BAY, WI 54311
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13134-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255007
—
WI
01
—
13134-33
ADVANCE PRACTICE NURSE PRESCRIBER
WI
01
—
218182-30
REGISTERED NURSE
WI
Enumeration date
07/26/2023
Last updated
01/22/2024
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