Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4235-033 | WI |
NPI | 1154626729 |
---|---|
Provider Name | Media S Esser |
First Address | Green Bay, WI 54305-2487 |
Second Address | Green Bay, WI 54301-3581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2011 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144479-30 | REGISTERED NURSE (01) | WI |
4235-033 | ADVANCED PRACTICE NURSE PRESCRIBER (01) | WI |
ESS104354702 | NEONATAL NURSE PRACTITIONER (01) |