Individual
MATTHEW KOLONICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7242
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
118986
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
244546-30
WI
Other
Enumeration date
12/29/2018
Last updated
01/29/2019
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