Bautch, Gregory

Bautch, Gregory is an individual health care provider with primary practice located at 2809 N Park Drive Ln , Appleton WI 54911-1603. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Bautch, Gregory can be contacted via phone (920) 738-4600.

Contact Information

Primary practice address
2809 N Park Drive Ln Appleton WI 54911-1603
Phone: (920) 738-4600
Fax: (920) 738-4792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 97064 Wisconsin

Profile Details

NPI number 1750324000
LBN Legal business name Bautch, Gregory
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750324000 NPPES
Wisconsin MEDICAID 43834500

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