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Individual

ASHELEY ROBYN GOERGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
9555 76TH ST STE 1200, PLEASANT PRAIRIE, WI 53158-1984
(262) 671-7300
(262) 671-7315
Mailing address
6308 8TH AVENUE, ATTN: MEDICAL STAFF OFFICE, KENOSHA, WI 53143
(262) 656-2218
(262) 653-5850

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1881-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42874700
WI
Enumeration date
05/26/2006
Last updated
05/25/2017
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