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Individual

MRS. CYNTHIA VERCAUTEREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.O.T.A

Contact information

Practice address
600 S WEBSTER AVE, GREEN BAY, WI 54301-3503
(920) 432-3213
(920) 432-0614
Mailing address
600 S WEBSTER AVE, GREEN BAY, WI 54301-3503
(920) 432-3213
(920) 432-0614

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
126
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40635000
WI
Enumeration date
04/02/2008
Last updated
04/02/2008
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