Individual
LAURA BOSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311
(920) 288-8000
Mailing address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9626
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43959300
—
WI
Enumeration date
07/13/2006
Last updated
10/09/2019
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