Healthcare Provider Details

I. General information

NPI: 1689694911
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: 07/20/2006
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 S VAN BUREN ST
GREEN BAY WI
54301-3526
US

IV. Provider business mailing address

PO BOX 13508
GREEN BAY WI
54307-3508
US

V. Phone/Fax

Practice location:
  • Phone: 920-433-8287
  • Fax: 920-433-8765
Mailing address:
  • Phone: 920-433-8287
  • Fax: 920-433-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateNULL

VIII. Authorized Official

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