Individual
MICHELLE MANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N9168 CHERRY MEADOW DR, APPLETON, WI 54915-4681
(920) 284-5784
Mailing address
9900 BREN RD E, MAIL ROUTE MN 008-B213, MINNETONKA, MN 55343-9664
(920) 574-1255
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
147545-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790069599
—
WI
Enumeration date
09/28/2011
Last updated
08/03/2020
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