Healthcare Provider Details

I. General information

NPI: 1023920733
Provider Name (Legal Business Name): COLLEEN SUE MESSNER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 BELLEVUE ST
GREEN BAY WI
54302-2210
US

IV. Provider business mailing address

1150 BELLEVUE ST
GREEN BAY WI
54302-2210
US

V. Phone/Fax

Practice location:
  • Phone: 920-272-7643
  • Fax: 920-448-2252
Mailing address:
  • Phone: 920-272-7643
  • Fax: 920-448-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number11268030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: