Individual
CORINA L GERCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1800 LAWRENCE DR, DE PERE, WI 54115
(920) 983-3220
(920) 983-3226
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1960
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1960-023
LICENSE
WI
Enumeration date
04/04/2006
Last updated
09/20/2023
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