Healthcare Provider Details

I. General information

NPI: 1437573086
Provider Name (Legal Business Name): CATHARINE AUNE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHARINE THOMASON CRNP

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2253 W MASON ST
GREEN BAY WI
54303-4706
US

IV. Provider business mailing address

2253 W MASON ST
GREEN BAY WI
54303-4706
US

V. Phone/Fax

Practice location:
  • Phone: 920-327-7300
  • Fax: 920-327-7301
Mailing address:
  • Phone: 920-327-7300
  • Fax: 920-327-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9187-033
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-088552
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9187
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: