Healthcare Provider Details

I. General information

NPI: 1942822614
Provider Name (Legal Business Name): NEHA KAPASI GREGOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 S WEBSTER AVE
GREEN BAY WI
54301-3505
US

IV. Provider business mailing address

744 S WEBSTER AVE
GREEN BAY WI
54301-3505
US

V. Phone/Fax

Practice location:
  • Phone: 920-433-3500
  • Fax:
Mailing address:
  • Phone: 920-433-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036.165753
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: