Individual
JENNAH A.L. HAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2641 DEVELOPMENT DR, GREEN BAY, WI 54311-4240
(920) 338-6868
(920) 338-6869
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
223532-30
WI
363LF0000X
Family Nurse Practitioner
Primary
8713-33
WI
Other
Enumeration date
06/27/2018
Last updated
03/27/2020
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