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1760494512
JEFFERY P ANTONISSEN
GREEN BAY, WI
NPI
1760494512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: WI 113583)
Enumeration Date
2006-08-12
Last Update Date
2024-04-09
Business Address
JEFFERY P ANTONISSEN CRNA
2845 GREENBRIER RD
GREEN BAY, WI 54311-6519
Phone number: 920-288-3388
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Mailing Address
JEFFERY P ANTONISSEN CRNA
1035 KEPLER DR
GREEN BAY, WI 54311-8320
Phone number: 920-490-9046
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