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LYNNETTE LEONA CLANCY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
130862
WI
363LF0000X
Family Nurse Practitioner
Primary
1390
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43902300
WI
Enumeration date
07/12/2006
Last updated
09/15/2016
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