person
Diane Matilda Pivonka, MS,RN,APNP
Adult Psychiatric/Mental Health Clinical Nurse Specialist in Green Bay, Wisconsin
NPI 1457583163

Diane Matilda Pivonka is an Adult Psychiatric/Mental Health Clinical Nurse Specialist based in Green Bay, WI and is specialized in Psychiatric/Mental Health, Adult. Diane Matilda Pivonka practices in Green Bay, WI and has the professional credentials of MS,RN,APNP. The NPI Number for Diane Matilda Pivonka is 1457583163 and holds a License No. 1822-033 (Wisconsin).

The current practice location address for Diane Matilda Pivonka is 1499 6Th St, Green Bay, WI and can be reached out via phone at 920-497-6161 and via fax at 920-498-0476.

Location: 1499 6Th St, Green Bay, WI, 54304-2252
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Provider Profile Details
NPI Number
1457583163
Provider Name
Diane Matilda Pivonka
Credential
MS,RN,APNP
Provider Entity Type
Individual
Gender
Female
Address
1499 6Th St, Green Bay, WI, 54304-2252
Phone Number
920-497-6161
Fax Number
920-498-0476
Provider Enumeration Date
08/13/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
41252600 05 WI
institution
Provider Business Practice Location Address Details
Address
1499 6Th St
City
State
Zip
54304-2252
Phone Number
920-497-6161
Fax Number
920-498-0476
person
Provider Business Mailing Address Details
Address
1499 6Th St
City
State
Zip
54304-2252
Phone Number
920-497-6161
Fax Number
920-498-0476
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Psychiatric/Mental Health, Adult
Taxonomy
License No.
1822-033 (Wisconsin)
Definition
Definition to come...
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