Individual
DR. NANCY JEAN HOMBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3329 N RICHMOND ST, APPLETON, WI 54911
(920) 380-2719
(920) 380-2755
Mailing address
3329 N RICHMOND ST, APPLETON, WI 54911
(920) 380-2719
(920) 380-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19584
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30158000
—
WI
01
—
AH6655370
BNDD
—
Enumeration date
09/12/2005
Last updated
08/31/2012
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