Individual
PAM E VERKUILEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5320 W MICHAELS DRIVE, APPLETON, WI 54913
(920) 882-8200
(920) 882-8210
Mailing address
5320 W MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8210
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
94980
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43879200
—
WI
Enumeration date
08/16/2005
Last updated
07/08/2007
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