Provider Demographics
NPI:1467482612
Name:POMRENING, EVE LYN (APNP)
Entity Type:Individual
Prefix:MRS
First Name:EVE
Middle Name:LYN
Last Name:POMRENING
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2105 E ENTERPRISE AVE
Mailing Address - Street 2:STE 111
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7862
Mailing Address - Country:US
Mailing Address - Phone:920-731-6611
Mailing Address - Fax:920-731-6732
Practice Address - Street 1:2105 E ENTERPRISE AVE
Practice Address - Street 2:STE 111
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7862
Practice Address - Country:US
Practice Address - Phone:920-731-6611
Practice Address - Fax:920-731-6732
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2850-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2850-033OtherSTATE LICENSE
2006000604OtherANCC CERTIFICATION NUMBER
2006000604OtherANCC CERTIFICATION NUMBER