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Individual

MARY JO KOHLER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
229 S MORRISON ST, APPLETON, WI 54911-5725
(920) 832-2783
Mailing address
8007 EXCELSIOR DR, MADISON, WI 53717-1962
(608) 829-5247

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2829
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36002700
WI
Enumeration date
06/17/2006
Last updated
07/08/2007
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