Individual
MS. GRETA M KOSTAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54935
(920) 907-7000
(920) 907-7012
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 647-6326
(414) 671-8860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1274-033
WI
363L00000X
Nurse Practitioner
Primary
83758-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41262800
—
WI
Enumeration date
08/23/2006
Last updated
02/20/2020
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