Individual
CHLOE L PUSTINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 E CAPITOL DR, APPLETON, WI 54911-8728
(920) 831-5050
(920) 738-6507
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7178
WI
363AM0700X
Medical Physician Assistant
PAR-0000015390
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831802339
—
WI
Enumeration date
12/29/2022
Last updated
05/28/2024
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