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Individual

MICHELE ANN LADURON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
340 N GREEN BAY AVE, SUITE 1, GILLETT, WI 54124-9325
(920) 855-2823
(920) 855-6343
Mailing address
340 N GREEN BAY AVE, GILLETT, WI 54124-9325
(920) 855-2823
(920) 855-6343

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1075-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11014110
WI
01
1134250905
GPCC NPI
WI
01
1851477913
CMH NPI
WI
01
390848401050
CMH ANTHEM
WI
Enumeration date
09/30/2005
Last updated
03/18/2013
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