Individual
JEAN M MCHENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3263 EATON ROAD, GREEN BAY, WI 54311
(920) 433-3456
Mailing address
3263 EATON ROAD, GREEN BAY, WI 54311
(920) 433-3456
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1766
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1766-033
LICENSE
WI
Enumeration date
12/09/2005
Last updated
03/14/2014
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