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General NPI Number Information
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NPI Number | 1619675790
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Entity Type | Individual
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Provider Name | AVERY ANN LEBOWITZ APNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 1550 MIDWAY PL
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City | MENASHA
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State | WI
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Zip | 54952-1165
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Country | US
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Telephone | 920-727-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 RIDGECREST LN
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City | KAUKAUNA
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State | WI
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Zip | 54130-4323
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Country | US
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Telephone | 317-345-0928
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 13491-33
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License Number State | WI
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