TINA BROSSOW (NPI# 1518444694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518444694 |
| Entity Type | Individual |
| Full Name | TINA BROSSOW |
| Credential | NP |
| Practice Address |
3263 Eaton Rd Green Bay WI 54311-6830 |
| Mailing Address |
N16012 Cty Rd T Withee WI 54498-8353 |
| Practice Telephone | 9204336700 |
| Practice Fax Number | 9204336830 |
| Mailing Telephone | 7153607543 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2019-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8487-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 123 Main, Eau Claire, WI 54701 | 8888521988 | |
| 744 S Webster Ave, Green Bay, WI 543013505 | 9204457222 | 9204457289 |
| 949 N 9th St, Milwaukee, WI 532331422 | 4142267000 |
| Street Address |
3263 EATON RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-6830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154306611 | Todd A Winney | Physical Therapist | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2005-12-07 |
| 1407405012 | Ashley M Hall | Nurse Practitioner | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2019-09-06 |
| 1841787785 | Emily R Bourguignon | Physician Assistant | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2018-04-17 |
| 1386146082 | Dylan A. Valentine | Registered Nurse | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2018-03-08 |
| 1558860205 | Daniel J Roenz | Physical Therapist | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2018-02-08 |
| 1992216162 | Baycare Clinic, LLP | Neurological Surgery | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2017-10-16 |
| 1497285480 | Daniel J Verhagen | Physical Therapist | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2017-06-13 |
| 1831623610 | Alyssa R Torn | Physical Therapist | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2017-04-18 |
| 1548619117 | Bellin Memorial Hospital Inc | Clinic/Center | 3263 Eaton Rd, Suite 1, Green Bay, WI 54311-6830 | 2016-06-06 |
| 1326496316 | Kayla Lynn Schisel | Physical Therapist | 3263 Eaton Rd, Green Bay, WI 54311-6830 | 2016-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
| 1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| Find all providers in zip 54311 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353763 | Tiffany Dahlke | Nurse Practitioner | 2427 Bluestone Pl, Green Bay, WI 54311-6433 | 2020-03-30 |
| 1285121707 | Deanna Danelle Olk | Nurse Practitioner | 917 Lincoln St, Green Bay, WI 54303-3625 | 2018-04-19 |
| 1306221619 | Karen M Kroll | Nurse Practitioner | 1630 Commanche Ave Ste 102, Green Bay, WI 54313-5753 | 2015-07-28 |
| 1770968760 | Esmaeil Ben Kamali | Nurse Practitioner | 725 S Webster Ave Ste 201, Green Bay, WI 54301-3500 | 2015-07-20 |
| 1427338730 | Natasha M Koehler | Nurse Practitioner | 2749 E Carrera Ct, Green Bay, WI 54311-7278 | 2011-08-18 |
| 1780982397 | Seth Patrick Moore | Nurse Practitioner | 879 Mather St, Green Bay, WI 54303-3651 | 2011-03-06 |
| 1316263569 | Chris Edwin Anibal | Nurse Practitioner | 744 South Webster Avenue, Green Bay, WI 54305-3500 | 2010-04-13 |
| 1184956864 | Douglas A Bartelt | Nurse Practitioner | 464 Cardinal Lane, Green Bay, WI 54313-9569 | 2010-02-05 |
| 1750504916 | Heather Mary Weber | Nurse Practitioner | 622 Bodart St, Green Bay, WI 54301 | 2007-04-10 |
| 1346314937 | Denise Mary Brilliant | Nurse Practitioner | 2340 E Mason St, Green Bay, WI 54302-3746 | 2006-11-17 |
| Find all providers in GREEN BAY | ||||
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| 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.