KELLY ELIZABETH HALBACH (NPI# 1740718105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740718105 |
| Entity Type | Individual |
| Full Name | KELLY ELIZABETH HALBACH |
| Credential | PA-C |
| Practice Address |
744 S Webster Ave Green Bay WI 54301-3505 |
| Mailing Address |
W3559 County Road B Hilbert WI 54129 |
| Practice Telephone | 9204333500 |
| Mailing Telephone | 9209891098 |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2017-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
744 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851398283 | Sampoornima Setty | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2005-06-30 |
| 1447858857 | Caycie N Bray | Physical Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-16 |
| 1326645029 | Nikki Lee Leow | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-06 |
| 1033726914 | Patricia M Slempkes | Occupational Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-09-25 |
| 1255941746 | Cassandra Toellner | Anesthesiologist Assistant | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-08-09 |
| 1376151951 | Dayna Elizabeth Schneider | Speech-Language Pathologist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-07-20 |
| 1164045092 | Robyn W Lauritsen | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-27 |
| 1831711860 | Ashley Elizabeth Mijal | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-13 |
| 1336760883 | Veronica B Hoppe | Pharmacist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-06 |
| 1386264521 | Brian Joseph Eggener | Radiology | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932439 | Kristin N Schultz | Physician Assistant | 1715 Dousman Street, Green Bay, WI 54307-9070 | 2005-06-15 |
| 1689167942 | Marissa Adrian | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-06-12 |
| 1396284154 | Jerald Dietrich Charles | Physician Assistant | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | 2017-02-13 |
| 1831424118 | Angela Mk Brashears | Physician Assistant | 2502 S Ashland Ave, Green Bay, WI 54304-5252 | 2009-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821612045 | Cassidy Renee Thomas | Physician Assistant | 1111 Delafield St Ste 209, Waukesha, WI 53188-3403 | 2020-06-03 |
| 1982056768 | Luke Harbers | Physician Assistant | 6226 Bankers Rd Ste 11, Mount Pleasant, WI 53403-9799 | 2016-07-06 |
| 1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
| 1346577954 | Darren Rosser | Physician Assistant | 2931 S 108th St, West Allis, WI 53227-3519 | 2009-11-03 |
| 1033359401 | Matthew S. Bay | Physician Assistant | 1818 N. Meade St Suite 240 West, Fox Valley Surgical Associates, Appleton, WI 54911-3496 | 2009-02-25 |
| 1265657068 | Surgical and Rehab Services Inc | Physician Assistant | E4051 Steven Way, Spring Green, WI 53588-9271 | 2007-04-16 |
| 1992844385 | Jill Ann Schumacher | Physician Assistant | 2265 90th St, Eau Claire, WI 54703-0181 | 2007-02-05 |
| 1609915073 | Brian Felix Robinson | Physician Assistant | S725 Turner Valley Rd, Mondovi, WI 54755-8331 | 2007-02-05 |
| 1124176383 | William Henry Price | Physician Assistant | 4819 5th Ave, Unit 2, Kenosha, WI 53140-2924 | 2007-01-06 |
| 1619032919 | Michael R Depew | Physician Assistant | 1650 S. 41st St., Lakeshore Orthopedics, Manitowoc, WI 54220 | 2006-12-27 |
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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.