Individual
LAURA M NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2710 EXECUTIVE DR, GREEN BAY, WI 54304-5496
(920) 496-4700
Mailing address
2710 EXECUTIVE DR, PO BOX 19070, GREEN BAY, WI 54304-5496
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33414
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31833600
—
WI
Enumeration date
06/30/2006
Last updated
07/31/2015
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