Individual
COLLEEN K MICELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
135 JACKSON ST, OSHKOSH, WI 54901-4713
(920) 303-8100
(920) 745-4701
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2935-33
WI
363LF0000X
Family Nurse Practitioner
2935
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36020500
—
WI
Enumeration date
09/29/2006
Last updated
11/17/2024
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