Individual
NYLE C NETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-3388
(920) 288-3370
Mailing address
3305 N BALLARD RD, STE A, APPLETON, WI 54911-9001
(920) 202-3363
(920) 939-3827
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
129657
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44325000
—
WI
Enumeration date
08/12/2006
Last updated
11/17/2022
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