Individual
ANGELA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1411 N TAYLOR DR, SHEBOYGAN, WI 53081-3043
(920) 457-4858
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15756-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100373880
—
WI
Enumeration date
04/02/2025
Last updated
11/14/2025
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