Healthcare Provider Details

I. General information

NPI: 1861667362
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF WI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 S. ONEIDA ST. SUITE 107
GREEN BAY WI
54304
US

IV. Provider business mailing address

2605 S. ONEIDA ST. SUITE 107
GREEN BAY WI
54304
US

V. Phone/Fax

Practice location:
  • Phone: 920-432-0031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: SUSAN MARIE ODEGAARD
Title or Position: DIRECTOR, BUS. OPERS.
Credential:
Phone: 414-289-3796