Individual
JENNIFER BANHOLZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 254-3854
Mailing address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14377-033
WI
363LF0000X
Family Nurse Practitioner
14377
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100266819
—
WI
Enumeration date
11/01/2023
Last updated
04/23/2024
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