Individual
JOSEPHINE M MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
2430 E MASON ST, GREEN BAY, WI 54302-3759
(920) 445-7377
Mailing address
N8931 COUNTY ROAD DK, DYCKESVILLE, WI 54217-9685
(701) 610-6169
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R19389
ND
363LF0000X
Family Nurse Practitioner
2536
MN
363LF0000X
Family Nurse Practitioner
4055
WI
363LF0000X
Family Nurse Practitioner
Primary
A-122356
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076372
—
IA
01
—
15689
WELLMARK BLUE CROSS BLUE SHIELD
IA
05
—
19534
—
ND
01
—
P1200504
RR MEDICARE
MN
Enumeration date
09/07/2006
Last updated
03/28/2025
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