Perdomo, Amy E

Perdomo, Amy E is an individual health care provider with primary practice located at 1160 Kepler Dr , Green Bay WI 54311-8321. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Perdomo, Amy E can be contacted via phone (920) 288-5630.

Contact Information

Primary practice address
1160 Kepler Dr Green Bay WI 54311-8321
Phone: (920) 288-5630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 8778 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 8778 Wisconsin

Profile Details

NPI number 1679052104
LBN Legal business name Perdomo, Amy E
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2018
Last updated Dec 1st, 2021 - about 5 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 1679052104 NPPES
Wisconsin MEDICAID 100082580
Wisconsin MEDICAID 100082621

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