Individual
MS. CAROL A. RAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
725 S WEBSTER AVE, THE NEURO TEAM, GREEN BAY, WI 54301-3500
(920) 433-7995
(920) 433-3458
Mailing address
PO BOX 23400, THE NEURO TEAM, GREEN BAY, WI 54305-3400
(920) 433-7995
(920) 433-3458
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
65003
WI
363L00000X
Nurse Practitioner
472-33
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
472033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43825200
—
WI
Enumeration date
02/07/2008
Last updated
12/29/2014
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