Individual
COLLEEN MARX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(920) 320-2436
(920) 320-5187
Mailing address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(920) 320-2436
(920) 320-5187
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2149-033
WI
363LF0000X
Family Nurse Practitioner
Primary
2149
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41185600
—
WI
01
—
P00120686
MEDICARE RAILROAD
WI
Enumeration date
08/17/2006
Last updated
03/05/2026
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