NPI | 1619861671 |
---|---|
Entity Type | Organization |
Authorized Contact | VALERIE AMSTADT Physician Assistant 920-296-4306 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2025-06-04 |
Last Update Date | 2025-08-18 |