Healthcare Provider Details

I. General information

NPI: 1548983281
Provider Name (Legal Business Name): REBECCA L SIRNA DNP, APNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N GREEN BAY RD
NEENAH WI
54956-1954
US

IV. Provider business mailing address

N1606 ERDINE LN
HORTONVILLE WI
54944-9293
US

V. Phone/Fax

Practice location:
  • Phone: 920-729-6088
  • Fax:
Mailing address:
  • Phone: 920-574-1606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13108-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: