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Individual

KATHLEEN S WANGERIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP, FNP-BC

Contact information

Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3500
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10620
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2019049684
AMERICAN NURSES CREDENTIALING CENTER
Enumeration date
12/09/2020
Last updated
03/19/2024
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