Healthcare Provider Details

I. General information

NPI: 1508155698
Provider Name (Legal Business Name): NEHA THAPA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 UNIVERSITY AVE
GREEN BAY WI
54311
US

IV. Provider business mailing address

812 CORMIER RD # 203
GREEN BAY WI
54304-4707
US

V. Phone/Fax

Practice location:
  • Phone: 920-431-2303
  • Fax:
Mailing address:
  • Phone: 920-709-9964
  • Fax: 920-709-9964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number61347-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: