DR. BONNIE RAE NUSSBAUM (NPI# 1114071289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114071289 |
| Entity Type | Individual |
| Full Name | DR. BONNIE RAE NUSSBAUM |
| Credential | PH.D. |
| Practice Address |
3600 Velp Ave Ste 4-a Green Bay WI 54313-6503 |
| Practice Telephone | 9208847445 |
| Practice Fax Number | 9208447449 |
| Mailing Telephone | 9208847445 |
| Mailing Fax Number | 9208447449 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1598-057 | WI | Behavioral Health & Social Service Providers |
| Street Address |
3600 VELP AVE STE 4-A |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54313-6503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823420 | Martha Lynn Drew | Licensed Practical Nurse | 3101 Molly Brown Lane, Green Day, WI 54313 | 2019-04-17 |
| 1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
| 1649727108 | Amanda Marie Mckeefry | Dental Hygienist | 2304 Lineville Rd, Suite 101, Green Bay, WI 54313 | 2016-09-01 |
| 1326594813 | Kaylee Schartner | Dental Hygienist | 2304 Lineville Road, Suite 100, Suamico, WI 54313 | 2016-08-25 |
| 1134500226 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Road, Green Bay, WI 54313 | 2015-06-15 |
| 1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1407092737 | Sara Ann Anderson | Registered Nurse | 2691 Shade Tree Ln, Green Bay, WI 54313 | 2008-12-16 |
| 1467601344 | Melissa Lea Socha | Speech-Language Pathologist | 2153 School Lane, Suamiro Elementary, Green Bay, WI 54313 | 2008-09-16 |
| 1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
| Find all providers in zip 54313 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407979206 | William David Laakso | Psychologist | 700 N Adams St, Green Bay, WI 54301-5145 | 2007-04-08 |
| 1124154612 | Todd Lee Hamilton | Psychologist | 2339 Cedar Rdg, Green Bay, WI 54313-5700 | 2007-02-26 |
| 1801954474 | Eric John Lund | Psychologist | 1575 Allouez Ave, Green Bay, WI 54311-5639 | 2006-12-05 |
| 1407920283 | Kevin Wayne Miller | Psychologist | 2131 S Webster Ave, Suite 105, Green Bay, WI 54301-2288 | 2006-11-20 |
| 1063513125 | Gerald Joseph Wellens | Psychologist | 130 E Walnut Street, Suite 603, Green Bay, WI 54301 | 2006-09-25 |
| 1326564949 | Michelle Schoenleber | Psychologist | 130 E Walnut St, Green Bay, WI 54301-4239 | 2017-08-15 |
| 1245688993 | Andrea Labine, Ph.d LLC | Psychologist | 1039 W Mason St, 116, Green Bay, WI 54303-1842 | 2016-06-02 |
| 1558799940 | Matthew Vendlinski | Psychologist | 2851 University Ave, Green Bay, WI 54311-5855 | 2013-10-22 |
| 1639501323 | Mandy J Kumpula | Psychologist | 2851 University Ave, Green Bay, WI 54311-5855 | 2013-08-05 |
| 1508128901 | Althea L. Noukki | Psychologist | 111 N Jefferson St, Green Bay, WI 54301-5005 | 2012-06-12 |
| Find all providers in GREEN BAY | ||||
Please comment or provide details below to improve the information on DR. BONNIE RAE NUSSBAUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.