Individual
MS. MARCIA A TEN HAKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, APNP
Contact information
Practice address
720 S. VANBUREN ST, GREEN BAY, WI 54301
(920) 433-3420
(920) 433-3788
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2470-33
WI
367A00000X
Advanced Practice Midwife
Primary
71807-32
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41197000
—
WI
Enumeration date
08/24/2006
Last updated
02/05/2019
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