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Contact Information

COUNTY OF GREEN LAKE
571 COUNTY ROAD A
GREEN LAKE, WI54941
 Phone: 920-294-4070
 Fax: 920-294-4139
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for COUNTY OF GREEN LAKE · (Female)

NPI # 1780867408
Status Active
Credentials
Entity Individual
Enumeration date 12/17/2007
Last updated 07/03/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • WI Medicaid 42139800
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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