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General NPI Number Information
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NPI Number | 1225587512
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Entity Type | Individual
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Provider Name | SANDRA RENEE PELNAR C.N.M., W.H.N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 10/30/2018
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Provider Practice Location Address
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Address Line | 720 S VANBUREN ST SUITE 101
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City | GREEN BAY
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State | WI
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Zip | 54301
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Country | US
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Telephone | 920-433-3420
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Fax | 920-338-6859
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Provider Business Mailing Address
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Address Line | 1400 BELLINGER ST
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 7297-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 148924-32
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License Number State | WI
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