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NPI Code Detail

MEDICARE: ROSE GONTARZ

MEDICARE:   ROSE  GONTARZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1100520WI

General Provider Information

NPI Number : 1356277248
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE GONTARZ
Provider Business Mailing Address
First Line : 2810 HOWARD CMNS APT 202
Second Line :
City : GREEN BAY
State : WI
Zip : 54313-9298
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2845 GREENBRIER RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-6519
Country : US
Telephone Number : 636-438-8837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2026
Last Update Date : 06/19/2026

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Directions to “ ROSE GONTARZ ” Practice Location

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