Individual provider · Type 1 NPI
Paul Antonissen, APNP
Family Nurse Practitioner · De Pere, WI
NPI number
1174096747
Active
Practice location
3957 Garrett St
De Pere, WI 54115-1655
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 8973-33 (WI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1174096747
Paul Antonissen, APNP's National Provider Identifier is 1174096747, issued on Jan 7, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in De Pere, WI. The record was last updated on Jan 7, 2019.