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1457583163
DIANE MATILDA PIVONKA
GREEN BAY, WI
NPI
1457583163
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult
(Licence: WI 1822-033)
Enumeration Date
2009-08-13
Last Update Date
2010-02-12
Business Address
-- DIANE MATILDA PIVONKA MS, RN, APNP
1499 6TH ST
GREEN BAY, WI 54304-2252
Phone number: 920-497-6161
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Mailing Address
-- DIANE MATILDA PIVONKA MS, RN, APNP
1499 6TH ST
GREEN BAY, WI 54304-2252
Phone number: 920-497-6161
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