Individual
CORI E BORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-7984
(920) 433-7974
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019082657
AMERICAN NURSES CREDENTIALING CENTER
—
Enumeration date
04/08/2020
Last updated
05/26/2021
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