Healthcare Provider Details

I. General information

NPI: 1285626846
Provider Name (Legal Business Name): CANDENA L ALLENBRAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 GREENBRIER RD
GREEN BAY WI
54311-6519
US

IV. Provider business mailing address

1481 MAPLE HILLS DR
GREEN BAY WI
54313-3953
US

V. Phone/Fax

Practice location:
  • Phone: 920-288-4560
  • Fax:
Mailing address:
  • Phone: 816-695-9692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number56157
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: