Individual
MS. BONNIE L GROESSL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
2149 VELP AVE, SUITE 205, GREEN BAY, WI 54303-5424
(920) 434-8500
(920) 468-9791
Mailing address
2987 DURHAM RD, GREEN BAY, WI 54311-7296
(920) 468-9315
(920) 468-9791
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
79614
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43845200
—
WI
Enumeration date
08/31/2006
Last updated
06/08/2009
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