Individual
KRISTIN KOERTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-8389
(920) 431-3667
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1878
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42871000
—
WY
Enumeration date
08/30/2006
Last updated
10/06/2017
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