NPI 1073994133
Kim Tavener
Practice location
- Address
- 923 Eliza St, Green Bay, WI 54301-3234
- Phone
- (920) 965-4700
- Fax
- (920) 965-4701
Registered specialties
Optician
Primary
Registry record
- NPI
- 1073994133
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 15 Jun 2015
- Record last updated
- 15 Jun 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.