Organization
MEDICATION INNOVATIONS L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY WENTLAND APNP (NURSE PRACTITIONER/OWNER)
(920) 965-7716
Entity
Organization
Contact information
Practice address
1039 W MASON ST, GREEN BAY, WI 54303-1842
(920) 965-7716
(920) 496-7922
Mailing address
1039 W MASON ST, GREEN BAY, WI 54303-1842
(920) 965-7716
(920) 496-7922
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
911033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43888800
—
WI
01
—
S55910
UPIN
WI
Enumeration date
08/24/2007
Last updated
08/24/2007
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