Individual
DR. NANA SARKOAH IVY FENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
519 S MONROE AVE, GREEN BAY, WI 54301-4017
(920) 435-6601
(920) 436-3840
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
036.129852
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
82547-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82547-20
SATE OF WISCONSIN
WI
Enumeration date
03/25/2010
Last updated
08/15/2023
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