Individual
CHRISTINA L. CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147
(262) 249-4660
(262) 249-7128
Mailing address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4660
(262) 249-7128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9353
WI
363LF0000X
Family Nurse Practitioner
209017362
IL
363LF0000X
Family Nurse Practitioner
APRN.CNP.019992
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100092173
—
WI
Enumeration date
12/06/2016
Last updated
11/30/2021
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