Individual
GABLE K HOLDERNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-4848
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6006-33
WI
363LF0000X
Family Nurse Practitioner
6006-33
WI
Other
Enumeration date
07/22/2014
Last updated
01/11/2022
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