Doctor Name: | MIRANDA MARIE HINTZ |
NPI Number: | 1013377969 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APNP |
License Number: | 6830-33 |
Business Practice Address: | 744 S Webster Ave Green Bay, WI - 543013505 |
Business Phone Number: | 9204337457 |
Business Fax Number: | 9204337453 |
Mailing Address: | Po Box 22487, GREEN BAY |
State: | WI |
Postal Code: | 543052487 |
Phone Number: | 9204457222 |
Fax Number: | 9204457289 |
NPI Enumeration Date: | 03/03/2016 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 6830-33 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |