Individual
TANYA ELMERGREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
1531 S MADISON ST, APPLETON, WI 54915-1800
(920) 738-2000
Mailing address
4131 W LOOMIS RD STE 300, GREENFIELD, WI 53221-2059
(414) 325-7246
(414) 325-3770
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8001-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8001-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073610
—
WI
05
—
100209146
—
WI
Enumeration date
11/15/2017
Last updated
08/30/2022
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