Healthcare Provider Details

I. General information

NPI: 1609248269
Provider Name (Legal Business Name): ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 DOUSMAN ST
GREEN BAY WI
54303-3211
US

IV. Provider business mailing address

1701 DOUSMAN ST
GREEN BAY WI
54303-3211
US

V. Phone/Fax

Practice location:
  • Phone: 920-498-8600
  • Fax:
Mailing address:
  • Phone: 920-498-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS PITZEN
Title or Position: MARKET DIRECTOR-FINANCE OPERATIONS
Credential:
Phone: 920-431-3047