Individual
JENNA MAE SPUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APNP, FNP-C
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9382-33
WI
363LF0000X
Family Nurse Practitioner
9382-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094063
—
WI
01
—
F06193041
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
09/09/2019
Last updated
11/21/2024
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