Provider Demographics
NPI:1811349970
Name:ZEHREN, MARISSA LEIGH (APNP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:LEIGH
Last Name:ZEHREN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:LEIGH
Other - Last Name:ROLLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:301 BAY PARK SQ
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5104
Practice Address - Country:US
Practice Address - Phone:920-592-9475
Practice Address - Fax:920-592-9479
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6997-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily